脳卒中は急性期病院入院中に栄養状態悪化

この論文も、急性期脳卒中患者の栄養状態が、入院後10日間で悪化することを示した報告です。

Mosselman MJ, Kruitwagen CL, Schuurmans MJ, Hafsteinsdóttir TB.　Malnutrition and risk of malnutrition in patients with stroke: prevalence during hospital stay.　J Neurosci Nurs. 2013 Aug;45(4):194-204. doi: 10.1097/JNN.0b013e31829863cb.

対象は73人の脳卒中患者で、10日間フォローできたのは23人のみです。23人の栄養状態は入院時、91％栄養状態良好、9％低栄養のおそれあり、0％低栄養でした。10日後は35％栄養状態良好、39％低栄養のおそれあり、26％低栄養でした。

以上より急性期病院入院後10日間で、急性期脳卒中患者の栄養状態が悪化することが示唆され、入院時だけでなく入院期間中の栄養スクリーニングが重要といえます。

急性期病院での栄養評価の推移に関する研究は難しい、と個人的に思っていました。しかし、このような形の研究であれば日本でも実現できますね。より多くの対象者数や他の疾患でも同様な研究をすることで、急性期病院での栄養評価と栄養管理の重要性を訴えたいですね。

Abstract

BACKGROUND:

Although various studies have shown high prevalence of malnutrition in hospitalized patients with stroke, recent studies on how the nutritional status of patients with acute stroke develops during the first weeks of hospital stay are scarce. Information is lacking concerning the identification of patients with stroke who are at risk of malnutrition during an acute hospital stay, because these patients may have a significant chance to improve their nutritional status.

PURPOSE:

This study aimed to investigate the prevalence of malnutrition and risk of malnutrition of patients with acute stroke during the first 10 days of hospitalization.

METHODS:

A prospective, descriptive study was conducted in a neurological department of a university hospital in The Netherlands. Seventy-three patients with acute stroke were included, of which 23 patients could be followed up after 10 days. The nutritional status was determined with the Mini Nutritional Assessment at admission and after 10 days.

RESULTS:

At admission, 5% of the patients (n = 73) were malnourished, 14% were at risk of malnutrition, and 81% were well nourished. Of the patients who could be followed up (n = 23), at admission, no patients were malnourished, 9% were at risk of malnutrition, and 91% were well nourished; whereas 10 days later, 26% of these patients were malnourished, 39% were at risk of malnutrition, and 35% were well nourished. This means that, within the followed-up group, the proportion of patients with malnutrition or risk of malnutrition increased significantly during hospital stay from 9% to 65%.

CONCLUSIONS:

Our study shows that the prevalence of malnutrition and risk of malnutrition in patients with acute stroke increases strongly during the first 10 days of admission. Therefore, screening of the nutritional status of these patients throughout this period is highly recommended to enable timely nutritional intervention and nutritional management of these patients.