Abstract WP137: Premorbid Malnutrition as Assessed by Nutritional Risk Index is Associated With Poor Short-Term Outcome in Patients With Ischemic Stroke

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Introduction: Malnutrition has negative consequences for stroke patients. However, impact of poor nutritional status before stroke onset on the functional outcome in patients with ischemic stroke remains unclear.Hypothesis: Therefore, we investigated the prognostic role of premorbid undernutrition using objective assessment method, Nutritional Risk Index (NRI), in patients with ischemic stroke.Methods: A consecutive 1,248 patients who were admitted within 7 days after ischemic stroke onset between March 2010 and December 2015 were included. We assessed initial nutritional status using NRI, and NRI formula as follows: NRI = (1.519 х serum albumin, g/dL) + {41.7 х present weight/ideal body weight (kg)}. The patients were categorized into three groups on the basis of NRI [No risk (NRI >97.5), Moderate risk (NRI 83.5–97.5), and Severe risk (NRI <83.5)]. We evaluated the short-term outcomes using a modified Rankin Scale (mRS) at three-months after stroke onset. We divided patients into two groups with favorable outcome (mRS score ≤2) and unfavorable outcome (mRS score ≥3). We compared the clinical characteristics and NRI between two groups.Results: Among the included patients (mean age, 67 years, male, 63.1%), 322 (25.8%) patients had unfavorable outcome. The unfavorable outcome group was older and more likely to have atrial fibrillation, lower body mass index, and higher initial NIHSS. The lower NRI patients (Moderate risk and Severe risk) were more frequent in unfavorable outcome group (50.7% vs. 32.0% and 12.7% vs. 2.7%, P <0.001). After adjustment for covariates, lower NRI groups were independently associated with a higher risk of unfavorable outcome [Odds ratio (95% confidence interval); Moderate risk 2.75 (1.23 – 6.13); Severe risk 4.29 (1.93 – 9.62), P for trend <0.001].Conclusion: This study demonstrated that the lower NRIs predicted unfavorable outcome at 3 months following ischemic stroke. This suggests that premorbid undernutrition could be a modifiable risk factor for prognosis following stroke.

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