TY - JOUR
T1 - Impaired Nutritional Condition After Stroke From the Hyperacute to the Chronic Phase: A Systematic Review and Meta-Analysis
AU - Huppertz, V.
AU - Guida, S.
AU - Holdoway, A.
AU - Strilciuc, S.
AU - Baijens, L.
AU - Schols, J.M.G.A.
AU - van Helvoort, A.
AU - Lansink, M.
AU - Muresanu, D.F.
N1 - Funding Information:
Support for this work has been received from Maastricht University, Maastricht, Netherlands and from Danone Nutricia Research, Utrecht, Netherlands.
Funding Information:
The authors would like to thank the Research and Innovation Data Science department of Danone Nutricia Research for the contribution to the statistical methods and analysis, Claudia van den Berg for her support as a third reviewer, and Daan Snoeks for the literature search.
Funding Information:
VH and JS received financial support for their research. LB is a consultant for Phagenesis Limited, Manchester, United Kingdom.
Publisher Copyright:
Copyright © 2022 Huppertz, Guida, Holdoway, Strilciuc, Baijens, Schols, van Helvoort, Lansink and Muresanu.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Background: Malnutrition is common after stroke and can affect rehabilitation and healthcare costs. A comprehensive overview of stroke patients' nutritional condition from the hyperacute to the chronic phase is lacking. This systematic review aimed to investigate the prevalence of impaired nutritional condition (INC) across the continuum of care in specific phases after stroke.Methods: CAB ABSTRACTS, Embase, MEDLINE, were used to collect studies published between 01-01-1999 and 26-08-2020. Primary and secondary outcomes were prevalence of INC and prevalence of malnutrition, respectively. Exploratory outcomes were prevalence of INC at follow-up, nutritional examination methods, prevalence of dysphagia, stroke severity, adverse events, and continent-specific prevalence of INC. A random-effects meta-analysis model was used to estimate the phase-specific pooled prevalence of INC and malnutrition.Results: The dataset consisted of 78 study groups selected over a total of 1,244 identified records. The pooled prevalence of INC and malnutrition were 19% (95%CI:7-31) (N = 4) and 19% (95%CI:9-29) (N = 3), 34% (95%CI:25-43) (N = 34) and 26% (95%CI:18-35) (N = 29), 52% (95%CI:43-61) (N = 34) and 37% (95%CI:28-45) (N = 31), 21% (95%CI:12-31) (N = 3) and 11% (95%CI:0-24) (N = 3) and 72% (95%CI:41-100) (N = 3) and 30% (95%CI:0-76) (N = 2) in the hyperacute, acute, early subacute, late subacute, and chronic phase, respectively.Conclusion: INC and malnutrition are highly prevalent in all stages of stroke care. Since malnutrition has been shown to negatively affect clinical outcomes, mortality, and overall healthcare expenditure in stroke survivors, it is essential to examine and monitor the nutritional status of stroke patients throughout their care journey to guide and plan, timely nutritional support and dietary modification.
AB - Background: Malnutrition is common after stroke and can affect rehabilitation and healthcare costs. A comprehensive overview of stroke patients' nutritional condition from the hyperacute to the chronic phase is lacking. This systematic review aimed to investigate the prevalence of impaired nutritional condition (INC) across the continuum of care in specific phases after stroke.Methods: CAB ABSTRACTS, Embase, MEDLINE, were used to collect studies published between 01-01-1999 and 26-08-2020. Primary and secondary outcomes were prevalence of INC and prevalence of malnutrition, respectively. Exploratory outcomes were prevalence of INC at follow-up, nutritional examination methods, prevalence of dysphagia, stroke severity, adverse events, and continent-specific prevalence of INC. A random-effects meta-analysis model was used to estimate the phase-specific pooled prevalence of INC and malnutrition.Results: The dataset consisted of 78 study groups selected over a total of 1,244 identified records. The pooled prevalence of INC and malnutrition were 19% (95%CI:7-31) (N = 4) and 19% (95%CI:9-29) (N = 3), 34% (95%CI:25-43) (N = 34) and 26% (95%CI:18-35) (N = 29), 52% (95%CI:43-61) (N = 34) and 37% (95%CI:28-45) (N = 31), 21% (95%CI:12-31) (N = 3) and 11% (95%CI:0-24) (N = 3) and 72% (95%CI:41-100) (N = 3) and 30% (95%CI:0-76) (N = 2) in the hyperacute, acute, early subacute, late subacute, and chronic phase, respectively.Conclusion: INC and malnutrition are highly prevalent in all stages of stroke care. Since malnutrition has been shown to negatively affect clinical outcomes, mortality, and overall healthcare expenditure in stroke survivors, it is essential to examine and monitor the nutritional status of stroke patients throughout their care journey to guide and plan, timely nutritional support and dietary modification.
KW - nutritional status
KW - malnutrition
KW - neurorehabilitation
KW - stroke recovery
KW - stroke rehabilitation
KW - stroke
KW - SUBJECTIVE GLOBAL ASSESSMENT
KW - HEALTH-CARE PROFESSIONALS
KW - ACUTE ISCHEMIC-STROKE
KW - EATING DIFFICULTIES
KW - ELDERLY-PATIENTS
KW - CLINICAL-SIGNIFICANCE
KW - FUNCTIONAL OUTCOMES
KW - ENTERAL NUTRITION
KW - MALNUTRITION
KW - REHABILITATION
U2 - 10.3389/fneur.2021.780080
DO - 10.3389/fneur.2021.780080
M3 - (Systematic) Review article
C2 - 35178021
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 780080
ER -