Acute-phase Geriatric Nutritional Risk Index is associated with swallowing function after convalescent rehabilitation in older patients with ischemic stroke: A retrospective cohort study.

INTRODUCTION

Post‑stroke dysphagia and malnutrition both compromise recovery. Whether the Geriatric Nutritional Risk Index (GNRI) measured on acute admission predicts swallowing function after convalescent rehabilitation remains unclear.

METHODS

This study retrospectively analyzed 254 with ischemic stroke patients aged ≥ 65 y (median age 79.3 y; 141 men) who were admitted within 7 d of stroke onset and subsequently transferred to convalescent rehabilitation hospitals. GNRI was calculated within 3 d of acute admission. Swallowing function was assessed with the Functional Oral Intake Scale (FOIS). Multivariate linear regression analyses with FOIS on convalescent discharge included acute-phase GNRI, age, sex, brainstem lesion, premorbid modified Rankin Scale, National Instituted of Health Stroke Scale, hemoglobin, C-reactive protein, Functional Independence Measure, days to speech therapy initiation, and baseline FOIS, which were assessed at the time of admission to the acute hospital.

RESULTS

Fifty-one (20.1%) had malnutrition for GNRI < 92 on acute admission. Patients with malnutrition were lower FOIS on acute admission (P = 0.002) and convalescent discharge (P < 0.001) than patients without malnutrition. Multivariate linear regression analyses revealed that acute-phase GNRI (β = 0.151; P = 0.019), premorbid modified Rankin Scale (β = -0.149; P = 0.009), C-reactive protein (β = 0.138; P = 0.024), days to speech therapy initiation (β = -0.116; P = 0.031), and baseline FOIS (β = 0.37; P < 0.001) were significantly associated with FOIS on convalescent discharge.

CONCLUSIONS

Acute‑phase GNRI may predict swallowing function after convalescent rehabilitation in older patients with ischemic stroke.