Prevalence of malnutrition and its risk factors in stroke patients residing in an infirmary

Abstract

Introduction: The aim of this study was to investigate the prevalence of malnutrition, and its associated risk factors, in stroke patients residing in an infirmary in Hong Kong. Methods: A cross-sectional retrospective study of 61 stroke patients residing in an infirmary was conducted. Baseline demographic data, including age, gender, smoking habit, and alcohol consumption, were obtained on admission. Nutritional status was assessed according to anthropometric parameters. Malnutrition was defined as having a body mass index (BMI) of below 18.5 kg per square metres for both gender and a serum albumin level of less than 35 g/L. 12 risk factors associated with malnutrition were evaluated according to established protocols. Results: 61 of the 93 patients assessed had a history of cardiovascular accident and gave consent to participate in the study. Among them were 28 (46 percent) women and 33 (54 percent) men. The mean length of stay of these patients was 850 days (or 28 months). The mean age of these patients was 76 (standard deviation 12.8) years. Among the patients, five (8.2 percent) were malnourished and 56 (91.8 percent) were adequately nourished. There were no significant differences in the distribution of eight risk factors between the malnourished and nourished groups. These risk factors were a previous history of alcohol consumption, comorbidities (five or more), polypharmacy (five or more), diabetes mellitus, impaired functional status of daily living, impaired mobility (wheelchair- or bed-bound), tube-feeding, and edentulism. Insufficient data was available to assess the effects of two risk factors: depressed mood and impaired cognitive function. The distribution of another two risks factors (previous history of smoking and dysphagia) was significantly different between the malnourished and nourished groups. Odds ratios of smoking and dysphagia associated with malnourishment were approximately 3.3 and 2.6, respectively. Conclusion: Five of 61 (8.2 percent) stroke patients residing in an infirmary were malnourished. Two risk factors significantly associated with malnutrition were previous history of smoking and dysphagia. It is recommended that smoking history be elicited during routine history-taking of all stroke patients and particular nutritional attention be given to these at-risk patients. It is also emphasised that the management of dysphagia should follow a standardised protocol and form an integral element of patient care.