Systemic inflammation and sarcopenia in recovery stage of stroke: The negative impact on functional rehabilitation outcomes

Abstract

To determine how systemic inflammation relates to sarcopenia and its impact on functional outcomes in the recovery stages of stroke. A retrospective cohort study was performed in consecutive patients admitted to convalescent rehabilitation wards. Patients with acute or chronic high-grade inflammatory diseases were excluded. Systemic inflammation was evaluated using the modified Glasgow Prognostic Score (mGPS). Sarcopenia was defined as a loss of skeletal muscle mass and decreased muscle strength with the cut-off values set by Asian Working Group for Sarcopenia. The primary outcome was the motor domain of the Functional Independence Measure (FIM-motor). Univariate and multivariate analyses were used to determine whether mGPS was associated with sarcopenia and FIM-motor at discharge. The present study included 204 patients (mean age of 74.1 years, 109 men, and 95 women) for analysis. An mGPS score of 0, 1 and 2 was assigned to 149 (73.0%), 40 (19.6%) and 13 (6.4%) patients, respectively. Sarcopenia was diagnosed in 81 (39.7%) patients and independently associated with stroke history (odds ratio [OR] 1.890, P = 0.027), premorbid modified Rankin scale (OR 1.520,P = 0.040), body mass index (OR 0.858, P = 0.022), and mGPS score (OR 1.380, P = 0.021). Furthermore, the mGPS score was independently associated with FIM-motor at discharge (Beta = −0.134, P = 0.038). Systemic inflammation is closely associated with sarcopenia and poor functional outcomes in the recovery stage of stroke. Early detection of systemic inflammation and sarcopenia can help promote both adequate exercise and nutritional support to restore muscle mass and improve functional recovery in the post-stroke patients.