A Comparative Study Of Three Methods For Evaluating The Nutritional Status Of Hospitalized Patients With Stroke

Objective : In this study,we investigated the nutritional status of hospitalized patients with stroke by using the questionnaire of nutritional status,SGA and NRS-2002,to understand the status of nutritional status and nutritional support in patients with stroke.Methods:In this study,a random survey from January 2015 to February 2016 in stroke patients hospitalized in Xingtai People’s Hospital,investigation and nutritional status of 91 cases of patients who met the inclusion criteria.Collect the general condition of the patients,anthropometric indices(height,weight,body mass index,triceps skinfold thickness,upper arm circumference,upper arm muscle circumference and calf maximum circumferential diameter),laboratory examination results(hemoglobin,red blood cells,white blood cells,total protein and ALBumin),swallowing dysfunction rating scale(Kubota drinking water test)to evaluate patients with swallowing function,the National Institutes of health,neural function defect score(NIHSS)table evaluation of patients with mental impairment.The nutritional status evaluation scale including the nutritional status of patients with stroke assessment of European Nutritional Risk Screening method(NRS-2002)and Subjective Global Assessment(SGA).The nutritional status of patients with stroke assessment includes two parts: A and B in patients with stroke or A 1 or B 2 are malnourished.Nutritional risk screening NRS-2002 standard: NRS-2002 total score greater than or equal to 3 decision for nutritional risk,NRS-2002 < 3 does not exist table nutritional risk.SGA contains 8: 8 items at least five grade B for mild to moderate malnutrition and at least five C class can be as severe malnutrition.The rest is good nutrition.T test was used to compare the nutritional status of groups of related factors,the x2 test or rank transformation of non parametric test.Analysis of the correlation between the biochemical indexes using the Pearson linear correlation analysis.NRS-2002 score and biochemical and anthropometric indices correlation analysis using multiple regression analysis.The level of test set for alpha = 0.05,with P<0.05 considered to have significant difference.Results:1 Application of stroke patients nutrition status questionnaire,NRS-2002 and evaluation method of SGA and anthropometric indices,biochemical examination results evaluation the nutritional status of stroke patients,by malnutrition detection rate from high to low as follows: cerebral stroke nutritional status questionnaire(69.2%),SGA(59.3%),NRS-2002(42.9%)ALB(35.2%),MAMC(25.3%),TSF(23.1%)and Hb(22.0%).2 Bivariate correlation analysis of BMI,TSF,MAMC,ALB and Hb nutrition related indicators,BMI and TSF,MAMC and Hb are positively correlated,both P < 0.05,correlation coefficient r as follows: 0.404,0.643 0.293.There was a positive correlation between TSF and Hb,P = 0.001,correlation coefficient r=0.265;MAMC and ALB and Hb exist positive correlation,both P < 0.001,the correlation coefficient r as follows: 0.378 and 0.573.There was a positive correlation between ALB and Hb,P=0.001,the related coefficient r=0.542.3 According to the evaluation result of stroke the questionnaire of the nutritional status and age for the evaluation of good nutrition group and malnutrition group respectively(54.7±8.67)years and(65.4±12.3)years;SGA evaluation method in good nutrition group and malnutrition group evaluation of age respectively(58.5±9.25)years and(66.4±11.6)years;nutrition risk screening 2002 method for evaluation of good nutrition group and malnutrition group evaluation of age respectively(56.8±8.57)years and(66.2±12.1)years old.Three groups of methods for evaluating nutritional status of malnourished group age were greater than good nutrition group(both P < 0.05).4 According to the evaluation result of stroke the questionnaire of the nutritional status,good nutrition group BMI,TSF,AMC and MAMC mean value followed by 23.8kg/m2,14.3mm,26.1cm and 28.7cm,malnutrition group BMI,TSF,AMC and MAMC average value in order to 23.4kg/m2,11.5mm,24.2cm and 27.3cm,good nutrition group of TSF,AMC and MAMC value was significantly higher than that of malnutrition group(both P <0.05).NRS-2002 score and ALBumin,hemoglobin,between TSF and MAMC were exists negative correlation(correlation coefficients were respectively-0.617,-0.37,-0.251,-0.303 and P < 0.05),and BMI and total protein without significantly related(P > 0.05).5 Appraisal of mild stroke with brain stroke the questionnaire of the nutritional status,moderate stroke,moderate to severe stroke and the patients with severe stroke rate of malnutrition followed by 52.6%,68.3%,100% and 100%.Swallowing function is normal,doubtful and difficult malnourished people who accounted for 57.1%,70.0% and 90.0%,respectively.6 To stroke the questionnaire of the nutritional status and SGA and NRS-2002 method for evaluation of the results were cross classified: brain stroke the questionnaire of the nutritional status of SGA and the evaluation results,the difference was not statistically significant(P=0.051).Brain stroke the questionnaire of the nutritional status and NRS-2002 evaluation results,the difference was statistically significant(P=0.003).Compared the results of NRS-2002 with SGA,the difference was statistically significant(P=0.001).The detection rate of malnutrition from big to small are: 69.2% stroke nutritional status questionnaire(63/91),SGA 59.3%(54/91),NRS-2002 42.9%(39/91).Conclusions:1 The results indicate that the prevalence of malnutrition in stroke patients is higher than that of NRS-2002 and SGA,which is more suitable for clinical evaluation of the nutritional status of patients with stroke.2 Age,degree of neurological deficit and swallowing dysfunction are important factors on stroke patients nutritional status,elderly,severe neurological deficit and swallowing dysfunction of brain stroke patients with malnutrition occurred at a higher rate,should cause clinical attention.3 Stroke patients with triceps skin fold thickness,upper arm circumference,upper arm muscle circumference anthropometric indices,and ALBumin and hemoglobin search by the influence of nutritional status.It should be early to assess the nutritional status of patients with cerebral apoplexy,and formulate the plan reasonable nutritional support,improve the status of patients with malnutrition and improve the prognosis.