This study investigated the impact of malnutrition on all-cause mortality and cardiovascular events in patients with acute stroke in an observational study.Design and Method:
Among 140 patients aged 40–80 years who had acute stroke and were admitted for rehabilitation in Asahikawa Rehabilitation Hospital between 2010 and 2011, 48 patients followed up for more than 1 year after discharge were recruited. The geriatric nutritional risk index (GNRI) was used to assess the nutritional status of the patients and was calculated using the following formula: GNRI = (14.89 × serum albumin) + [41.7 × (body weight / body weight at BMI of 22)]. Malnutrition was defined as GNRI ≤96 at discharge.Results:
Mean age was 66.0 ± 8.7 years; mean systolic blood pressure was 132.8 ± 13.7 mmHg; and mean GNRI was 97.8 ± 6.9. The number of patients with GNRI ≤96 was 15 (31%). During the follow-up period (median: 60 months), 4 patients (8.3%) died. Three of them died of infection and 1 of them died of cardiopulmonary arrest. Eleven patients had cardiovascular events (22.9%) including 7 strokes, 3 heart failures and 1 acute coronary syndrome. Kaplan-Meier curves showed a significantly higher all-cause mortality in patients with GNRI ≤96 (log rank P = 0.027), whereas it did not show a significant difference in cardiovascular events between patients with GNRI ≤96 and > 96. In Cox regression analysis, GNRI is an independent determinant of all cause mortality after adjusting for age, gender, and systolic blood pressure.Conclusions:
Malnutrition is an independent determinant of all-cause mortality in patients with stroke, suggesting that it is important to evaluate and manage the nutritional status in those patients.