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Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial.

Abstract

BACKGROUND AND PURPOSE

Previous studies suggest that undernourished patients with acute stroke do badly. The data, however, are not robust. We aimed to reliably assess the importance of baseline nutritional status as an independent predictor of long-term outcome after stroke in a large prospective cohort enrolled in the Feed Or Ordinary Diet (FOOD) trial, a multicenter randomized trial evaluating various feeding policies.

METHODS

Patients admitted to hospital with a recent stroke were enrolled in the FOOD trial. Data on nutritional status and other clinical predictors of outcome were collected at trial entry. At 6 months, the coordinating center collected data on survival and functional status (modified Rankin Scale). Outcome assessment was done by researchers blinded to baseline assessments and treatment allocation.

RESULTS

Between November 1996 and November 2001, 3012 patients were enrolled, and 2955 (98%) were followed up. Of the 275 undernourished patients, 102 (37%) were dead by final follow-up compared with only 445 (20%) of 2194 patients of normal nutritional status (odds ratio [OR], 2.32; 95% CI, 1.78 to 3.02). After adjustment for age, prestroke functional state, and stroke severity, this relationship, although weakened, still held (OR, 1.82; 95% CI, 1.34 to 2.47). Undernourished patients were more likely to develop pneumonia, other infections, and gastrointestinal bleeding during their hospital admission than other patients.

CONCLUSIONS

These data provide reliable evidence that nutritional status early after stroke is independently associated with long-term outcome. It supports the rationale for the FOOD trial, which continues to recruit and aims to estimate the effect of different feeding regimes on outcome after stroke and thus determine whether the association observed in this study is likely to be causal.

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    Source

    Stroke 34:6 2003 Jun pg 1450-6

    MeSH

    Aged
    Body Weight
    Cohort Studies
    Cross Infection
    Female
    Follow-Up Studies
    Gastrointestinal Hemorrhage
    Humans
    Inpatients
    Logistic Models
    Male
    Nutrition Disorders
    Nutritional Status
    Odds Ratio
    Prospective Studies
    Randomized Controlled Trials as Topic
    Severity of Illness Index
    Stroke
    Survival Rate
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12750536

    Citation

    FOOD Trial Collaboration. "Poor Nutritional Status On Admission Predicts Poor Outcomes After Stroke: Observational Data From the FOOD Trial." Stroke, vol. 34, no. 6, 2003, pp. 1450-6.
    FOOD Trial Collaboration. Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial. Stroke. 2003;34(6):1450-6.
    FOOD Trial Collaboration. (2003). Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial. Stroke, 34(6), pp. 1450-6.
    FOOD Trial Collaboration. Poor Nutritional Status On Admission Predicts Poor Outcomes After Stroke: Observational Data From the FOOD Trial. Stroke. 2003;34(6):1450-6. PubMed PMID: 12750536.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial. A1 - ,, Y1 - 2003/05/15/ PY - 2003/5/17/pubmed PY - 2003/6/27/medline PY - 2003/5/17/entrez SP - 1450 EP - 6 JF - Stroke JO - Stroke VL - 34 IS - 6 N2 - BACKGROUND AND PURPOSE: Previous studies suggest that undernourished patients with acute stroke do badly. The data, however, are not robust. We aimed to reliably assess the importance of baseline nutritional status as an independent predictor of long-term outcome after stroke in a large prospective cohort enrolled in the Feed Or Ordinary Diet (FOOD) trial, a multicenter randomized trial evaluating various feeding policies. METHODS: Patients admitted to hospital with a recent stroke were enrolled in the FOOD trial. Data on nutritional status and other clinical predictors of outcome were collected at trial entry. At 6 months, the coordinating center collected data on survival and functional status (modified Rankin Scale). Outcome assessment was done by researchers blinded to baseline assessments and treatment allocation. RESULTS: Between November 1996 and November 2001, 3012 patients were enrolled, and 2955 (98%) were followed up. Of the 275 undernourished patients, 102 (37%) were dead by final follow-up compared with only 445 (20%) of 2194 patients of normal nutritional status (odds ratio [OR], 2.32; 95% CI, 1.78 to 3.02). After adjustment for age, prestroke functional state, and stroke severity, this relationship, although weakened, still held (OR, 1.82; 95% CI, 1.34 to 2.47). Undernourished patients were more likely to develop pneumonia, other infections, and gastrointestinal bleeding during their hospital admission than other patients. CONCLUSIONS: These data provide reliable evidence that nutritional status early after stroke is independently associated with long-term outcome. It supports the rationale for the FOOD trial, which continues to recruit and aims to estimate the effect of different feeding regimes on outcome after stroke and thus determine whether the association observed in this study is likely to be causal. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/12750536/full_citation L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000074037.49197.8C?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -