Introduction: It is a well described fact that elderly hospitalized patients lose weight, and this weight loss has been attributed to loss of muscle mass. On our acute Inpatient Stroke Rehabilitation Unit, patients with more severe deficits on admission appear to lose more weight than patients who are fairly functional. With this retrospective cohort study, we examined whether weight loss during stroke rehabilitation was associated with stroke severity as measured with the Functional Independence Measure (FIM) Score, and due to poor nutrition due to dysphagia or otherwise decreased food intake (estimated by Percent of Meal Consumed (PoMC)).
Methods: 420 ischemic stroke patients, admitted to the Burke Rehabilitation Hospital Inpatient Stroke Unit between 12/14 and 12/15, were included in this retrospective cohort study. Weight change per admission day, as well as motor, cognitive and total FIM Scores was recorded. Patients who had mechanically altered diet orders or thickened liquid orders were judged to be dysphagic, and nutritional intake was estimated by PoMC.
Results: Weight change per day during inpatient stroke rehabilitation was not correlated with gains in motor FIM (Pearson correlation 0.07, p=0.89) or cognitive FIM (Pearson Correlation -0.053, p=0.29) scores. Weight change per day was also not correlated with admission cognitive or motor FIM scores, indicating that stroke severity did not predict weight loss during admission. Of note, weight change per day was also not correlated with dysphagia, indicating that patient with swallowing difficulties were able to meet their nutritional needs through dietary modifications.
Conclusion: Weight changes after stroke do not appear to be correlated to stroke severity and stroke outcomes, as measured by the FIM Score. In our cohort, dysphagia was not an independent risk factor for weight loss. Future prospective trials will be required in order to assess which patients are at risk for weight loss, and whether weight loss is correlated with other measures of impairment.