Assessment Of The Incidence Of Post-stroke Malnutrition And Its Impact On Clinical Prognosis Based On GLIM Criteria

Objective:This study uses the Global Leadership Initiative on Malnutrition(GLIM)to assess the prevalence of malnutrition in stroke patients and to further explore the risk factors associated with malnutrition after stroke.The study also explores the risk factors associated with malnutrition after stroke and its relationship with the prognosis of patients’ disability.This will provide a basis for improving health professionals’ understanding of nutritional status,establishing a standardised and standardised operational model of nutritional support for stroke patients and preventing the occurrence of adverse outcomes.Methods:This study prospectively included stroke patients who were admitted to the Department of Neurology of the First Affiliated Hospital of Gannan Medical University from May 2022 to October 2022 and within 7 days of onset.All included patients were screened for nutritional risk within 24 hours of admission using the Nutritional Risk Screening 2002(NRS-2002)scale.Basic information(e.g.age,sex,etc.),disease history(hypertension,diabetes,coronary heart disease,chronic obstructive pulmonary disease,etc.),anthropometric indicators(height,weight,calf circumference,etc.)and laboratory indicators(fasting blood glucose,total cholesterol,very low density lipoprotein,etc.)were also collected,and the patients were assessed for nutritional status and divided into malnourished and normal nutrition groups according to GLIM criteria to calculate The prevalence of malnutrition in stroke patients was calculated.The clinical prognosis of all patients was assessed at 3 months of presentation using the modified Rankin scale(m RS).m RS scores ≥3 were defined as poor prognosis.SPSS 21.0 was used for statistical analysis of the data,and multi-factor logistic regression analysis was used to explore the risk factors for malnutrition and their relationship with clinical prognosis.Results:1.According to the diagnostic criteria and inclusion and exclusion criteria,202 stroke patients were finally included,including 133 males(65.8%)and 69 females(34.2%);198 patients with cerebral infarction and 4 patients with cerebral haemorrhage;97 patients(48.0%)were smokers;85 patients(42.1%)were alcohol drinkers;149patients(73.8%)had a history of hypertension;57 patients(28.2%)had a history of diabetes mellitus;14 patients(6.9%)had a history of coronary heart disease;16 patients(7.9%)had a history of atrial fibrillation.There were 149 cases(73.8%)with a history of hypertension,57 cases(28.2%)with a history of diabetes mellitus,14 cases(6.9%)with a history of coronary heart disease and 16 cases(7.9%)with a history of atrial fibrillation.2.Nutritional risk screening results: All 202 stroke patients were screened for nutritional risk.122 patients(60.4%)were at nutritional risk;100 patients(39.6%)were not at nutritional risk;stroke patients were more likely to be at nutritional risk.3.Malnutrition statistics: 72 patients(35.6%)were diagnosed as malnourished according to GLIM criteria,and 130 patients(64.4%)were not malnourished.4.Swallowing: 17 stroke patients(8.4%)had dysphagia,10 patients had malnutrition and 7 patients had no malnutrition.5.Results of univariate analysis of malnutrition in stroke inpatients: There was no statistically significant difference between the two groups in terms of length of onset,type of stroke,history of smoking,history of alcohol consumption,presence of hypertension,diabetes mellitus,hyperlipidaemia,coronary artery disease and atrial fibrillation(P>0.05).The differences in age,gender,body mass index,degree of neurological deficit and presence of swallowing disorder were statistically significant between the two groups(P<0.05).6.Multi-factor logistic regression analysis of risk factors for malnutrition in stroke inpatients suggested that independent risk factors for malnutrition in stroke inpatients included gender,body mass index,degree of neurological deficit,and coronary heart disease(P<0.05)(ORs 0.294,0.777,1.175,4.573,respectively).7.A univariate analysis of the prognosis of stroke patients showed no statistically significant differences in the length of time to onset,type of stroke,history of alcohol consumption,previous history of hypertension,previous history of diabetes mellitus,previous history of hyperlipidaemia,previous history of coronary heart disease and previous atrial fibrillation between the two groups(P>0.05).The differences in age,gender,body mass index,degree of neurological deficit,smoking and malnutrition were statistically significant between the two groups(P<0.05).8.Multi-factor logistic regression analysis of poor prognosis in stroke inpatients showed that independent risk factors for poor prognosis in stroke inpatients included age,degree of neurological deficit,and the presence of malnutrition(P<0.05)(ORs1.080,1.554,13.138 respectively).Conclusion:1.The incidence of malnutrition diagnosed according to GLIM criteria in the 202 stroke inpatients studied was 35.6%,a high incidence.Timely assessment of nutritional status on admission and early intervention are needed to reduce the occurrence of adverse outcomes.2.Gender,body mass index,degree of neurological deficit and swallowing disorders are risk factors for malnutrition in stroke inpatients.Independent risk factors for malnutrition in stroke inpatients are gender,body mass index,coronary artery disease and degree of neurological deficit.3.Gender,body mass index,degree of neurological deficit,smoking and malnutrition were risk factors for prognosis in stroke inpatients.Independent risk factors for poor prognosis in stroke inpatients were age,degree of neurological deficit and malnutrition,with malnutrition being the main influence in all three,followed by degree of neurological deficit.