Shinshu University, Graduate School of Medicine, Department of Medical Sciences, Matsumoto, Nagano, Japan; School of Health Sciences, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. Electronic address: [Email]
OBJECTIVE : Malnutrition during hospitalization affects the functional recovery and postdischarge destinations of elderly stroke patients. However, insufficient studies exist about nutritional status during hospitalization in the acute stroke phase in this population. This study determined factors of nutritional status changes during hospitalization in elderly patients in the acute phase of stroke, and investigated the relationship between nutritional status changes and improved activities of daily living and postdischarge destination. METHODS : This retrospective observational study included 205 acute-phase stroke patients admitted to Shinshu University Hospital from 2010-2016. Multiple regression analysis was conducted to determine relationships between nutritional status changes, patient characteristics, and improved activities of daily living. Binomial logistic regression analysis was used to determine the relationship between the postdischarge destination and nutritional status changes. RESULTS : Prevalence of malnutrition was 42% at admission and 76% at discharge. Factors affecting nutritional status changes at admission included Geriatric Nutritional Risk Index (β = -0.35, P < .001) and Barthel Index/feeding (β = 0.22, P = .002), and factors during hospitalization included age (β = -0.21, P < .001), ischemic stroke (β = 0.16, P = .008), and National Institute of Health Stroke Scale score (β = -0.29, P < .001). Significant associations of changes in geriatric nutritional risk index occurred with improved activities of daily living during hospitalization (β = 0.26, P < .001) and discharge to home (odds ratio = 1.11, 95% confidence interval: 1.03-1.19, P = .008). CONCLUSIONS : Many elderly patients in the acute phase of stroke with malnutrition exhibited worsening conditions during hospitalization, which was negatively associated with their activities of daily living abilities and postdischarge destinations. Nutritional status changes and associated factors must be evaluated during hospitalization in this patient population.