Malnutrition could predict 3-month functional prognosis in mild stroke patients: Findings from a Nationwide Stroke Registry

2021 ◽  
Vol 19 ◽  
Author(s):  
Haiqiang Qin ◽  
Anxin Wang ◽  
Yingting Zuo ◽  
Yaqing Zhang ◽  
Bo Yang ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Multivariable Analysis ◽  
Skinfold Thickness ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Stroke Registry ◽  
Arm Circumference ◽  
Mild Stroke ◽  
Mid Upper Arm Circumference

Background: Previous studies showed the inconsistent effects of malnutrition contributing to poor prognosis of stroke. The aim of this study is to explore the effect of malnutrition on 3-month functional prognosis of stroke patients with different stroke severity assessed by the national institute of health stroke scale (NIHSS). Patients with first-ever stroke were consecutively enrolled in a nationwide, multicenter, and prospective registry from March 2007 to January 2008. Methods: Nutritional status was assessed at admission. Malnutrition was defined by any abnormality of 6 nutrition indicators, including body mass index (BMI), mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), haemoglobin, albumin, and prealbumin. Stroke patients were classified into mild (NIHSS<8) and severe (NIHSS≥8) groups. Multivariable logistic regression was performed to assess the risk of poor functional prognosis [ modified Rankin Scale (mRS) ≥3] and mortality at 3-month follow-up in mild or severe patients with malnutrition at admission. A total of 755 patients with first-ever stroke were enrolled in the study. Results: Multivariable analysis showed that malnutrition independently contributed to a higher risk of mRS 3-6 at 3-month for mild stroke patients [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.04-3.34], but didn’t for severe stroke patients (OR 0.91, 95% CI 0.53-1.54) after adjusting for confounders including age, NIHSS, and infection et al. After adjusting for the potential confounders, malnutrition was still an independent risk factor for 3-month poor functional prognosis in mild stroke patients. Conclusion: Further investigation may be needed to illustrate the effects of improving nutritional status on stroke patients.

Abstract W P57: Thrombolytic Therapy in Patients With Mild Stroke: An Observational Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Jose G Romano ◽  
Eric E Smith ◽  
Li Liang ◽  
Hannah Gardener ◽  
Sara Camp ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Multivariable Analysis ◽  
Hospital Death ◽  
Stroke Patients ◽  
Short Term ◽  
Stroke Registry ◽  
Symptomatic Intracranial Hemorrhage ◽  
Mild Stroke ◽  
Independent Ambulation ◽  
Get With The Guidelines

Objective: Mild stroke has traditionally been excluded from thrombolytic treatment trials and only few series have reported outcomes after IV rtPA in this group. The objectives of this study are to determine the proportion of mild stroke patients treated with IV rtPA and evaluate complications and short-term outcomes in this population. Methods: We analyzed patients in the Get With The Guidelines-Stroke registry that arrived within 4.5 hours from symptom onset with a mild ischemic stroke defined as a baseline NIHSS ≤5 who received IV rtPA between May 2010 and October 2012. The following outcomes and complications were analyzed: in-hospital mortality, home discharge, independent ambulation, length of stay (LOS), in-hospital death, and symptomatic intracranial hemorrhage (sICH) <36 h. Multivariable analysis was performed for predictors of outcomes and complications. Results: Of 147,917 patients who arrived <4.5 hours, 39,821 were treated with IV rtPA, of whom 8,243 (20.7%) had an NIHSS ≤5. We analyzed 5,910 treated patients with NIHSS ≤5 and complete data. The mean baseline NIHSS was 3.5 (median 4); 98.2% arrived within 3 hours and 78.6% were treated within 3 hours. Outcomes and predictors of worse outcome are described in the table. There was no difference in short-term outcomes amongst those treated at 0-3 vs. 3-4.5 hours. Conclusions: A sizeable minority of ischemic stroke patients treated with IV rtPA have a NIHSS ≤5. sICH occurred at a low rate of 1.8% and about 30% of these patients were unable to return home and could not ambulate independently. Longer-term outcomes are needed to define predictors of poor outcome in this population and which patients may benefit most from treatment.

scholarly journals Nutritional status of hospitalized acute stroke patients

1998 ◽  
Vol 79 (6) ◽  
pp. 481-487 ◽  
Author(s):  
Salah E. Gariballa ◽  
Stuart G. Parker ◽  
Nick Taub ◽  
Mark Castleden
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Acute Stroke ◽  
Stroke Severity ◽  
Albumin Concentration ◽  
Serum Albumin Concentration ◽  
Stroke Patients ◽  
Significant Deterioration ◽  
Arm Circumference ◽  
Co Morbidity

The nutritional status of 201 hospitalized stroke patients was assessed from anthropometric, haematological and biochemical data in an observational prospective study. On admission, sixty-two (31%) stroke patients had BMI < 20, ninety-nine (49%) had a triceps skinfolds thickness below the 25th centile, twenty-five (12%) had a mid-arm circumference below the 25th centile and thirty-eight (19%) had a serum albumin concentration below 35 g/1. Baseline nutritional status was worse among those who later died or remained in hospital compared with those discharged and most patients who remained in hospital showed marked and significant deterioration in all measures of nutritional status within 4 weeks of hospitalization. After adjusting for age, stroke severity and co-morbidity, low serum albumin concentrations of these patients in hospital were a strong and independent predictor of death following acute stroke (odds ratio 1.13 (95% CI 1.01−1.27) for 1 g/1 lower serum albumin concentration).

scholarly journals Food Aversions and Cravings during Pregnancy: Prevalence and Significance for Maternal Nutrition in Ethiopia

1998 ◽  
Vol 19 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Tsegaye Demissie ◽  
N. M. Muroki ◽  
Wambui Kogi-Makau
Keyword(s):  
Nutritional Status ◽  
Maternal Nutrition ◽  
Skinfold Thickness ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Dietary Practices ◽  
Cross Sectional ◽  
Arm Circumference ◽  
Livestock Products ◽  
Mid Upper Arm Circumference

A cross-sectional study of the nutritional significance of food aversions and cravings during pregnancy was conducted on 295 women in southern Ethiopia between February and May 1995. A questionnaire was used to collect data on dietary practices. Mid-upper-arm circumference (MUAC), triceps skinfold thickness (TSFT), and weight measurements were used to assess nutritional status. Slightly fewer than three-quarters (71%) of the women craved one or more foods, whereas about two-thirds (65%) avoided at least one food. Cereal foods, despite being staple foods in the area, were avoided by more women (41%) than any other foods. Livestock products, which were scarce at the time of the study, were craved by more women (55%) than any other foods. Comparisons using various anthropometric indicators revealed that women who avoided foods had significantly higher MUAC and TSFT than those who did not ( p < .05), whereas there was no difference in nutritional status between women who craved foods and those who did not. However, those craving women who managed to get the desired foods had significantly higher weight gain ( p < .05), but not significantly higher MUAC or TSFT, than those who did not. Aversion and craving were positively associated (χ2 = 10.66, p < .001; odds ratio, 2.36). Thus, women who avoided foods were 2.4 times more likely to crave foods than those who did not avoid foods. This implies that aversion and craving are complementary processes geared towards ensuring optimal nutrition during pregnancy. Aversion results in the avoidance of monotonous diets, whereas craving calls for varied and nutritious foods. More research, however, is needed before such a conclusion is warranted.

Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

2021 ◽  
pp. 1-12
Author(s):  
Aparna Roy ◽  
T. V. Sekher
Keyword(s):  
Nutritional Status ◽  
Sensitivity And Specificity ◽  
Measurement Data ◽  
Anthropometric Measurement ◽  
Alternative Measure ◽  
Upper Arm ◽  
Male Adolescents ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

Description of Pregnant Women's Nutritional Status Based on The Mid-Upper Arm Circumference in Sundari Medan General Hospital In 2019

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
David Franli ◽  
Makmur Sitepu ◽  
Hotma Partogi Pasaribu ◽  
Sake Juli Martina
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
General Hospital ◽  
Upper Arm ◽  
Cross Sectional ◽  
Arm Circumference ◽  
Energy Stores ◽  
Cross Sectional Design ◽  
Mid Upper Arm Circumference ◽  
Observational Descriptive Study

Introduction. Chronic energy deficieny (CED) is a condition of a body characterized by low body weight and low energy stores, possibly limited physical capacity due to deprivation of food over a long period time. Ministry of Health ( Kemenkes) showed that in 2015, 305 out of 100.000 death of pregnant women is realated to malnutriotion and CED. Objective. The aim of this study is to determine the overview of pregnant women nutritional status based on mid-upper arm circumference (MUAC) in Sundari Medan General Hospital. Method. The study was an observational descriptive study with a cross sectional design. The samples of this study consists of pregnant women from Sundari Medan Genaral Hospital, who had fulilled the inclusion and esclusion criteria by total sampling. Results.. Among 60 samples, the prevalance of Non-CED woman (85%) was found higher than the mild malnutrition (15%). Conclusion. Prevalance of CED pregnant women was found higher in risky age, middle educated and high income family.  

scholarly journals Efficacy of mid-upper arm circumference in identification, follow-up and discharge of malnourished children during nutrition rehabilitation

2015 ◽  
Vol 9 (3) ◽  
pp. 268 ◽  
Author(s):  
Joseph Birundu Mogendi ◽  
Hans De Steur ◽  
Xavier Gellynck ◽  
Hibbah Araba Saeed ◽  
Anselimo Makokha
Keyword(s):  
Upper Arm ◽  
Malnourished Children ◽  
Arm Circumference ◽  
Nutrition Rehabilitation ◽  
Mid Upper Arm Circumference

scholarly journals A study of nutritional status, development of malnutrition and food consumption in hospitalized patients

2019 ◽  
Vol 3 (2) ◽  
pp. 66-80
Author(s):  
Anil Evrim Gungor ◽  
Perihan Arslan ◽  
Osman Abbasoglu
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Hospitalized Patients ◽  
Nutritional Risk ◽  
Food Services ◽  
Hospital Malnutrition ◽  
Arm Circumference ◽  
Nrs 2002 ◽  
Mid Upper Arm Circumference ◽  
Nutritional Risk Screening

Purpose: To investigate the nutritional status of patients on admission and during hospital stay, the factors leading to weight loss, and to evaluate patient satisfaction of hospital food. Methods: On admission, Nutritional Risk Screening (NRS-2002), weight, height, Body Mass Index (BMI), mid upper arm circumference (MAC) measurements were carried out; serum total protein and albumin levels were recorded. Upon discharge, measurements of weight, MAC were repeated, along with a food satisfaction questionnaire. Results: Patients with NRS-2002>3, BMI<20, were classified as nutrionally at risk which were 43.6% and 9.4% respectively. Of the patients, 77% lost weight (2.6±1.9 kg). Patients who were determined to be malnourished on admission by BMI and NRS-2002 stayed longer in hospital (p<0.0 and p<0.001, respectively). The relationships between weight loss and lenght of stay, use of medications and period of starvation were significant (p<0.0001, for each). Of the patients, 49.9% did not satisfy with the hospital food. Conclusions: Nutritional status of hospitalized patients should be screened with NRS-2002, assessed and monitored. Keywords: NRS-2002, hospital malnutrition, hospital food services

scholarly journals The Difference of Barthel Index Score Based on Stroke Severity, Weakness Side, and Onset of Physiotherapy in Ischemic Stroke Patients at Atma Jaya Hospital

2017 ◽  
Vol 6 (02) ◽  
pp. 15
Author(s):  
Agustina Novita Putri Soegiarto ◽  
Linda Suryakusuma ◽  
Jane Pelealu
Keyword(s):  
Ischemic Stroke ◽  
Barthel Index ◽  
Daily Living ◽  
Index Score ◽  
Stroke Severity ◽  
Activity Of Daily Living ◽  
Stroke Patients ◽  
Barthel Index Score ◽  
Cross Sectional ◽  
Stroke Registry

Background: Stroke is the third cause of disability that can affect the Activity of Daily Living (ADL). Ischemicstroke had higher incidence compared to hemorrhagic strokes. Rehabilitation in the form of physiotherapy canreduce the level of ADL dependencies, that is be measured by Barthel Index Score. Stroke severity, weaknessside, and physiotherapy onset can be factors that influence the success of physiotherapy to reducing the levelof ADL dependencies.Methods:A descriptive analytic study with a cross-sectional design in ischemic stroke patients using secondarydata from the Stroke Registry and medical records at Atma Jaya Hospital for the period of January 2016 toDecember 2017. The data were analyzed using Chi-Square.Results: Study on 110 subjects, consisted of 62 men(56.4%), aged divided by under of 58 years, and above of 58years were 52(47.3%) and 58 (52.7%). While subjects divided by stroke severity, i.e. minor, moderate, moderateto severe, and severe; 44 (40%), 58 (52.7%), 5 (4.5%), and 3 (2.7%) respectively. There were 77 participants(70%) had right side weakness and 33 participants (30%) were left side weakness. The changes of Barthel Indexof ADL score, were 73 (66.4%) improvement, 6 (5.5%) deterioration, and 31 (28.2%) remained. The study hasshown relationship between severity of stroke (p=0.008), weakness side (p=0.000), and physiotherapy onset(p=0.039) with the changes of Barthel Indexscore after treatment.Conclusion: There was a relationship between stroke severity, the weakness side of stroke, and physiotherapyonset with the better result of Barthel Index of ADL score after the physiotherapy.Keywords: Activity of Daily Living (ADL), Barthel Index, ischemic stroke, physiotherapy onset, stroke severity,Weakness side

scholarly journals ANTHROPOMETRIC PROFILE OF CHILDREN WITH CYANOTIC AND NONCYANOTIC CONGENITAL HEART DISEASE

2020 ◽  
Vol 15 (1) ◽  
pp. 1
Author(s):  
Mahrus Rahman ◽  
I Ketut Alit Utamayasa ◽  
Taufiq Hidayat ◽  
Roedi Irawan ◽  
Rina Elizabeth
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nutritional Status ◽  
Congenital Heart ◽  
Cyanotic Congenital Heart Disease ◽  
Upper Arm ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Impaired nutritional status is a frequent complication of congenital heart disease (CHD). Non cyanotic congenital heart disease (NC-CHD) have problem with lung overfl ow and heart failure. Consequences of Cyanotic congenital heart disease (C-CHD) are decrease pulmonary blood fl ow and prolong hypoxia. These conditions can have eff ect on nutritional status and outcome of surgery. This study aimed to compare anthropometric profi les of children with C-CHD and NC-CHD. Cross-sectional study conducted in 66 children, age 3 months until 5 years old who met inclusion criteria in Pediatric Cardiology Outpatient Unit Dr. Soetomo Hospital Surabaya in November 2012. A total of 66 children, consisted of 26 children with C-CHD and 40 children NC-CHD included in study. We measure weight, length/height, head circumference, upper arm circumference, and skin fold thickness. We used Chi Square test for statistical analysis with Confi dence Interval 95%. Mean age of both groups was 27.82 ± 16.63 months. Majority of NC-CHD was Ventricular Septal Defect (28.6%) and C-CHD was Tetralogy of Fallot (21.4%). There were no signifi cant diff erence from weight for age, length for age weight for length, head circumference for age, mid upper arm circumference for age, mid upper arm circumference for age, and skin fold thickness for age between children with C-CHD and NC-CHD (p= 0.80; 0.98;0.54 0.29; 0.80; 0.53 respectively). There were no diff erence in anthropometric profi les among children with cyanotic congenital heart disease and non-cyanotic congenital heart disease in this study.

Assessment and provision of rehabilitation among patients hospitalized with acute ischemic stroke in China: Findings from the China National Stroke Registry II

2017 ◽  
Vol 12 (3) ◽  
pp. 254-263 ◽  
Author(s):  
Janet Prvu Bettger ◽  
Zixiao Li ◽  
Ying Xian ◽  
Liping Liu ◽  
Xingquan Zhao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Multivariable Analysis ◽  
Thrombosis Prophylaxis ◽  
Stroke Patients ◽  
Multivariable Logistic Regression Model ◽  
Recommended Care ◽  
Stroke Registry ◽  
Factors Associated ◽  
Rehabilitation Assessment

Background Stroke rehabilitation improves functional recovery among stroke patients. However, little is known about clinical practice in China regarding the assessment and provision of rehabilitation among patients with acute ischemic stroke. Aims We examined the frequency and determinants of an assessment for rehabilitation among acute ischemic stroke patients from the China National Stroke Registry II. Methods Data for 19,294 acute ischemic stroke patients admitted to 219 hospitals from June 2012 to January 2013 were analyzed. The multivariable logistic regression model with the generalized estimating equation method accounting for in-hospital clustering was used to identify patient and hospital factors associated with having a rehabilitation assessment during the acute hospitalization. Results Among 19,294 acute ischemic stroke patients, 11,451 (59.4%) were assessed for rehabilitation. Rates of rehabilitation assessment varied among 219 hospitals (IQR 41.4% vs 81.5%). In the multivariable analysis, factors associated with increased likelihood of a rehabilitation assessment ( p < 0.05) included disability prior to stroke, higher NIHSS on admission, receipt of a dysphagia screen, deep venous thrombosis prophylaxis, carotid vessel imaging, longer length of stay, and treatment at a hospital with a higher number of hospital beds (per 100 units). In contrast, patients with a history of atrial fibrillation and hospitals with higher number of annual stroke discharges (per 100 patients) were less likely to receive rehabilitation assessment during the acute stroke hospitalization. Conclusions Rehabilitation assessment among acute ischemic stroke patients was suboptimal in China. Rates varied considerably among hospitals and support the need to improve adherence to recommended care for stroke survivors.

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