Acute-phase weight change and functional recovery during convalescent rehabilitation in older stroke patients.

BACKGROUND & AIMS: Malnutrition is common among patients with stroke, and weight change is an important marker of nutritional status associated with clinical outcomes. However, the association between acute-phase weight change and functional recovery during the convalescent rehabilitation (CR) phase remains unclear, particularly in older patients. This study examined the association between acute-phase weight change and walking independence in older patients with stroke.

METHODS

This retrospective cohort study included 650 patients aged ≥65 years admitted to a CR ward after acute stroke. Weight change was calculated using body weight at or before stroke onset and at CR ward admission. The primary outcome was time to walking independence. Kaplan-Meier analysis and multivariable Cox proportional hazards models were used.

RESULTS

During a median follow-up of 95 days, 44.9% of patients achieved walking independence. Greater acute-phase weight loss was significantly associated with a lower probability of achieving walking independence (log-rank P < 0.001). In multivariable analysis, patients with severe weight loss had a significantly lower likelihood of walking independence compared with those with slight weight loss or weight gain (hazard ratio, 0.63; 95% confidence interval, 0.46-0.85). Secondary sensitivity analyses excluding patients with prolonged acute hospitalization showed a stronger association. Restricted cubic spline analysis demonstrated a dose-response relationship between weight loss and reduced likelihood of walking independence.

CONCLUSIONS

Acute-phase weight loss was associated with a lower likelihood of achieving walking independence in older patients with stroke. Incorporating weight monitoring into acute-phase care may help promote functional recovery and walking independence.