Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Prevalence and Prognostic Significance of Malnutrition Risk in Patients With Acute Ischemic Stroke: Results From the Third China National Stroke Registry
First author：Guitao Zhang
Corresponding author： Gaifen Liu,Yongjun Wang
essential_information
- Person in charge：Guitao Zhang
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20200043
- Published time：2021-10-14
2021-10-14
Published articles
Journal：STROKE
Publication type: Original Contributions
IF(IF): 7.914
PMID: 34645284 Link To Pubmed Full text Download
Background And Purpose
Malnutrition has been proven to have an adverse effect on the stroke patients. It is associated with increases in complications, mortality, and poor neurological outcomes in acute ischemic stroke patients. Screening patients with ischemic for malnutrition might identify patients at high risk of adverse outcomes who might benefit from tailored treatments or interventions to prevent deterioration and improve prognosis. Among malnutrition scores, the controlling nutritional status (CONUT) index, Triglycerides-total Cholesterol-Body weight-Index(TCBI), and the geriatric nutritional risk index (GNRI) have been studied in patients with cancer，
Method
Study Population:CNSR-Ⅲ.The inclusion criteria are (1) older than 18 years old; (2) acute ischemic stroke,transient ischemic attack within 7 days of the index event;(3) informed consent provided by patients or legally authorized representatives. And we exclude patients who have no measurement of height, weight, laboratory parameters needed to calculate the index or follow-up recorded; we also excluded patients with a diagnosis of chronic lymphocytic leukemia. Statistical Analyses: The characteristics of all patients are reported as percentages for categorical variables, median (interquartile range) or mean (±standard deviation) for continuous variables. Statistical comparisons are appropriately carried out by the Pearson χ2 test, the Student t-test, or the Mann–Whitney U-test. Univariable and multivariable analyses with logistic regression are used to determine significant predictors of events. Receiver operating characteristic (ROC) curves are drawn for each model by plotting sensitivity versus one minus specificity. The power of each model to predict outcomes was calculated from the area under the ROC curve, the AUCs were compared using the z-test.
Conclusion
The prevalence of moderate or severe malnutrition risk in Chinese AIS patients ranged from 1.95% to 5.89%. Malnutrition risk in AIS patients was associated with increased risk of long-term mortality and major disability. Our study provides evidence supporting the prognostic significance of objective malnutrition scores after AIS.
Main results
Moderate to severe malnutrition risk was identified in 5.89%, 5.30%, and 1.95% of the Third China National Stroke Registry AIS patients according to the controlling nutritional status score, geriatric nutritional risk index, and prognostic nutritional index, respectively. At 1-year follow-up, 1143 participants (13.5%) experienced death or major disability. After adjustment for traditional risk factors, moderate to severe malnutrition risk was associated with high risk of composite events (odds ratio, 2.25 [95% CI, 1.75–2.90], for controlling nutritional status score; odds ratio, 2.10 [95% CI, 1.63–2.69], for geriatric nutritional risk index; odds ratio, 3.36 [95% CI, 2.33–4.84], for prognostic nutritional index; all P<0.01). Addition of the 3 malnutrition scores to different predicted scales (iScore and Acute Stroke Registry and Analysis of Lausanne) improved predictive ability for long-term poor outcomes validated by the integrated discrimination index (all P<0.05).