Irish journal of medical science · 2025
Malnutrition identified based on GLIM criteria and diet quality in post-stroke rehabilitation patients.
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Bahat Gülistan, Aydın Tuğba, Kesiktaş Fatma Nur, Ahısha Yiğit Can, Ören Meryem Merve, Erdoğan Tuğba, Öztürk Savaş, Karan Mehmet Akif, Cederholm Tommy
Аннотация
BACKGROUND: Malnutrition is one of the important consequences of stroke and has been strongly associated with negative clinical outcomes.
AIMS: We aimed to investigate (1) the prevalence of malnutrition based on the Global Leadership Initiative on Malnutrition (GLIM) criteria in post-stroke rehabilitation patients, (2) the associations of malnutrition with stroke-related clinical characteristics, and (3) the dietary intake of patients after stroke.
METHODS: Eighty-one post-stroke patients undergoing in-patient rehabilitation were included. Spasticity, motor function, ambulation levels, functionality and burden of co-morbidities were assessed making use of the Modified-Ashworth-Scale (MAS), Brunnstrom Staging, the Functional-Ambulation-Classification (FAC), the Barthel-Index and the Cumulative-Illness-Rating-Scale (CIRS), respectively. GLIM criteria were used for the diagnosis of malnutrition. We considered two alternative definitions of low muscle mass (LMM), i.e., skeletal muscle mass (SMM)/ height2, and SMM/body mass index (BMI). Dietary intake was evaluated using a 24-hour recall.
RESULTS: Malnutrition was present in 21% and 53.1% of the participants when SMM was adjusted for height2 and BMI, respectively. The MAS-hip [odds ratio (OR) = 14.973, p = 0.03], FAC (OR = 0.01, p = 0.002) and CIRS (OR = 2.33, p = 0.006) were independently associated with GLIM (LMM adjusted for height2)-identified malnutrition; while ankle spasticity by MAS was the only independent associate of GLIM (LMM adjusted for BMI)-identified malnutrition (OR = 0.36, p = 0.047). Of the 10 participants, nine did not reach a protein intake of at least 1 g/kg/d. The median daily intake of calories and elemental calcium was low.
CONCLUSIONS: Malnutrition was found to be highly prevalent among post-stroke rehabilitation patients, with prevalence varying based on the approach to the standardization of muscle mass and was associated with indicators of functional impairment.
AIMS: We aimed to investigate (1) the prevalence of malnutrition based on the Global Leadership Initiative on Malnutrition (GLIM) criteria in post-stroke rehabilitation patients, (2) the associations of malnutrition with stroke-related clinical characteristics, and (3) the dietary intake of patients after stroke.
METHODS: Eighty-one post-stroke patients undergoing in-patient rehabilitation were included. Spasticity, motor function, ambulation levels, functionality and burden of co-morbidities were assessed making use of the Modified-Ashworth-Scale (MAS), Brunnstrom Staging, the Functional-Ambulation-Classification (FAC), the Barthel-Index and the Cumulative-Illness-Rating-Scale (CIRS), respectively. GLIM criteria were used for the diagnosis of malnutrition. We considered two alternative definitions of low muscle mass (LMM), i.e., skeletal muscle mass (SMM)/ height2, and SMM/body mass index (BMI). Dietary intake was evaluated using a 24-hour recall.
RESULTS: Malnutrition was present in 21% and 53.1% of the participants when SMM was adjusted for height2 and BMI, respectively. The MAS-hip [odds ratio (OR) = 14.973, p = 0.03], FAC (OR = 0.01, p = 0.002) and CIRS (OR = 2.33, p = 0.006) were independently associated with GLIM (LMM adjusted for height2)-identified malnutrition; while ankle spasticity by MAS was the only independent associate of GLIM (LMM adjusted for BMI)-identified malnutrition (OR = 0.36, p = 0.047). Of the 10 participants, nine did not reach a protein intake of at least 1 g/kg/d. The median daily intake of calories and elemental calcium was low.
CONCLUSIONS: Malnutrition was found to be highly prevalent among post-stroke rehabilitation patients, with prevalence varying based on the approach to the standardization of muscle mass and was associated with indicators of functional impairment.