4.7 Article

Association between malnutrition and long-term mortality in older adults with ischemic stroke

Journal

CLINICAL NUTRITION
Volume 40, Issue 5, Pages 2535-2542

Publisher

CHURCHILL LIVINGSTONE
DOI: 10.1016/j.clnu.2021.04.018

Keywords

Malnutrition; Ischemic stroke; Elderly; Mortality; China

Funding

  1. National Key R&D Program of China [2017YFC1307900]
  2. National Natural Science Foundation of China [81901248, 81870946, 81530038]

Ask authors/readers for more resources

This study of older adults with ischemic stroke in China found that malnutrition was prevalent and associated with increased mortality. Different malnutrition indicators (CONUT, GNRI, PNI) all showed an association with higher risk of death. Further research is needed to evaluate the effectiveness of nutritional management in these patients.
Background & aims: Malnutrition is associated with poor prognosis of different diseases. This study aimed to investigate the association of malnutrition with long-term mortality of older adults with ischemic stroke in China. Methods: We selected patients aged >= 65 years with first-ever ischemic stroke from the Nanjing Stroke Registry Program. Malnutrition was defined according to the controlling nutritional status score (CONUT), the geriatric nutritional risk index (GNRI), and the prognostic nutritional index score (PNI), respectively. Multivariable Cox proportional hazards regressions and competing risk regressions were performed to explore the relationship between malnutrition and the risk of mortality in older adults with ischemic stroke. Results: Among 1065 enrolled patients, 60.5%, 46.7%, and 30.6% of patients were malnourished according to CONUT, GNRI, and PNI score. During a median follow-up of 4.74 (3.73-5.82) years, 205 (19.2%) patients died. In multivariate analysis, malnutrition (severe risk versus normal nutrition) was associated with significantly increased risk for mortality by the CONUT (adjusted hazard ratio [HR] 4.615, 95% confidence interval [CI] 1.373-15.514, P = 0.013), GNRI (adjusted HR 3.641, 95% CI 1.924-6.891, P < 0.001), and PNI score (adjusted HR 1.587, 95% CI, 1.096-2.297, P = 0.014). Furthermore, adding the malnutrition indexes to models modestly improved the predictive ability of mortality. Conclusions: Our study indicated that malnutrition was highly prevalent in older Chinese adults with ischemic stroke and associated with increased mortality. Further research is required to evaluate the efficacy of nutritional management in these patients. (c) 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available