Application Of Systematic Nutrition Assessment Program In Patients With Severe Stroke And Malnutrition

Objective Due to the disease characteristics of severe stroke patients in Neurological intensive care unit(NICU),the patients were easily lead to malnutrition which can affect its prognosis. Therefore, early nutritional assessment and systematic nutritional evaluation were help to guide the individualized nutritional support. This study was dedicated to conduct the systematic nutritional evaluation method for severe stroke with the risk of malnutrition patients, in order to better manage nutrition and improve the nutritional status of patients, reduce complications and improve the prognosis.Methods 122 severe stroke with risk of malnutrition patients were included in the experiment. The experimental group received the systematic nutritional evaluation method, while the control group adopted conventional nutritional evaluation method. Dynamic monitoring the biochemical indices of patients in the experimental group,comparing the change of nutrition indicators, complications and the prognosis between the two groups.Results 1.There were no statistically differences between the experimental group and the control group on patients’ age, sex, type of stroke, the level of nutrition indicators, neurological deficit, severe degree of disease on admission. 2. It is recommended for severe stroke patients during hospitalization to regularly monitored nutrition indicators for early detection of malnutrition3.Dynamic monitoring biochemical indices changes in the test group,we found that all of the biochemical indicators showed a downward trend, in which the serum albumin began to decline on the 3th day, the hemoglobin and the lymphocyte count were sharply decline on the 11 th day, the blood urea nitrogen began to rise on the 3th day. 4.There were no statistically differences between the experimental group and the control group on arm circumference, triceps skinfold thickness, serum albumin, hemoglobin, blood urea nitrogen, lymphocyte on the 7th day of NICU;however, the levels of arm circumference, triceps skinfold thickness, hemoglobin in the experimental group were higher than that in the control group on the 14 th day of NICU. 5. The rate of diarrhea and upper gastrointestinal bleeding、pulmonary infection, malnutrition were lower in the experimental group than that in the control group. 6. The experimental group patients have lower APACHE Ⅱ score and shorter NICU hospitalization time than that in the control group,P <0.01.Conclusions 1. Dynamic monitoring biochemical indexes changes for severe stroke can early detection of malnourished patients. 2.Systematic nutritional evaluation guide nutritional support may improve nutritional status of severe stroke with malnutrition risk patients. 3.Systematic nutritional evaluation can reduce severe stroke with the risk of malnutrition patients incidence of malnutrition, lung infections, diarrhea, upper gastrointestinal bleeding and other complications. 4.Systematic nutritional evaluation may superior to conventional nutritional evaluation on reduce severe stroke NICU hospitalization time and reduce the extent of critical illness(APACHE Ⅱ score), so it may be the ideal way of nutritional evaluation for patients with severe stroke.Background The aims of this meta-analysis were to evaluate the risk factors associated with lung infections in stroke patients and to provide evidence for prevention decisions.Methods We searched the Embase, Pub Med, EBSCO, and Web of Science databases to collect studies from January 2000 to July 2015.Results The meta-analysis identified 23 risk factors for lung infections in stroke patients, and the top 5, as ranked by order by odds ratio(OR) value [95% confidence interval(CI)], were as follows: multiple vertebrobasilar stroke, 22.99 [4.04, 130.83]; National Institutes of Health Stroke Scale(NIHSS) score >15 points, 14.63 [8.54, 25.08]; mechanical ventilation(MV), 10.20 [7.15, 14.57]; nasogastric tube use, 9.87 [6.21, 15.70]; and dysphagia, 7.50 [2.60, 21.65].Conclusion Therefore, preventive measures should be taken against these risk factors to reduce the incidence of lung infection.