Undernourished stroke patients have poor outcomes

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - A Korean study has shown that undernutrition markedly increases the risk of complications after a stroke, and is also associated with impaired recovery. "We were pretty surprised by it," Dr. Dong-Wha Kang told Reuters Health.

Kang and colleagues from the University of Ulsan College of Medicine in Seoul examined the impact of nutritional status on the outcomes of 131 stroke patients. Nutritional assessments were made within 24 hours of symptom onset and again after 1 week.

Undernutrition was diagnosed if patients had lost 10 percent or more of their weight in the past 3 months, or 6 percent or more in the week following admission, or if various protein levels in the blood were low.

At admission and at 1 week, 16 and 26 of the patients, respectively, were judged to be undernourished, according to the team's report in the Archives of Neurology.

The presence of undernutrition upon admission to the hospital raised the risk of post-stroke complications nearly 7-fold. Undernutrition at 1 week was associated with an almost 5-fold increased likelihood of a poor stroke outcome at 3 months.

Providing patients with an adequate amount of calories soon after a stroke may "favorably affect patient outcomes," suggest the authors of a related editorial.

Given these findings, Kang said, the next step would be to conduct a clinical trial to see if "strategic nutritional support improves clinical outcomes in stroke patients."

SOURCE: Archives of Neurology, January 2008.