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Wong HJ, Harith S, Lua PL, Ibrahim KA. Comparison of concurrent validity of different malnutrition screening tools with the Global Leadership Initiative on Malnutrition (GLIM) among stroke survivors in Malaysia. Sci Rep 2023; 13:5189. [PMID: 36997594 PMCID: PMC10063687 DOI: 10.1038/s41598-023-31006-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/06/2023] [Indexed: 04/01/2023] Open
Abstract
Individuals with stroke are at high malnutrition risk in both the acute and chronic phases. This study aimed to assess the validity of different malnutrition screening tools for stroke patients in rehabilitation phase. Participants in this study were 304 stroke patients from three hospitals in the East-Coast region of Peninsular Malaysia from May-August 2019. The concurrent validity of the Malnutrition Risk Screening Tool-Hospital (MRST-H), Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002) was assessed with the diagnostic criteria for malnutrition proposed by the Global Leadership Initiative on Malnutrition (GLIM-DCM). Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve were computed. MUST and MRST-H demonstrated good validity regardless of different age groups (> 80% sensitivity and specificity); meanwhile, MST and MNA-SF had fair validity, yet NRS-2002 had poor to fair validity with GLIM-DCM. Only MRST-H and NRS-2002 were significantly correlated with all anthropometric indices, dietary energy intake, and health-related quality of life in both age groups. In conclusion, MRST-H and MUST showed good concurrent validity with GLIM-DCM and can be considered as appropriate malnutrition screening tool in discriminating malnutrition among stroke individuals attending rehabilitation centre in Malaysia regardless of their age groups.
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Affiliation(s)
- Hui Jie Wong
- Faculty of Health Sciences, School of Nutrition and Dietetics, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300, Kuala Nerus, Terengganu, Malaysia
- Dietetic Unit, Karak Health Clinic, Ministry of Health Malaysia, Jalan Besar Karak, 28600, Bentong, Pahang, Malaysia
| | - Sakinah Harith
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300, Kuala Nerus, Terengganu, Malaysia.
| | - Pei Lin Lua
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Besut Campus, 22200, Besut, Terengganu, Malaysia
| | - Khairul Azmi Ibrahim
- Neurology Unit, Department of Medicine, Hospital Sultanah Nur Zahirah, Ministry of Health Malaysia, Jalan Sultan Mahmud, 20400, Kuala Nerus, Terengganu, Malaysia
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Buoite Stella A, Manganotti P. Enteral Nutrition and Hydration in Patients with Acute Stroke: Efficacy of an Automatic Pump System for Water Administration and Flushes-A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:8029. [PMID: 36298380 PMCID: PMC9609995 DOI: 10.3390/s22208029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Enteral nutrition is often prescribed in acute stroke to meet energy and fluid needs in patients with dysphagia. Tubes clogging represent a common complication of enteral formula delivery, requiring substitution and influencing nutrition administration. Frequent water flushes are recommended as one of the most effective procedures to prevent tube occlusion, but it might be time demanding and not consistently performed by the healthcare staff. This study aimed to assess the efficacy of an automatic flush pump, compared to a manual flush system, to prevent tubes' occlusions in acute-stroke patients, as this might affect nutrition and hydration. METHODS Gastrointestinal symptoms, nutrition and hydration biomarkers were also monitored to determine the different devices' safety. Sixty-two patients were included in the study and allocated to the "manual" or "automatic" flushes device. RESULTS The mean duration of data collection was 7 ± 2 days. Tube occlusions occurred in 22.6% of the patients in the "manual" group, whereas only one tube clogging was reported in the "automatic" group (p = 0.023). No significant differences between groups were reported for constipation and diarrhea frequency nor nutrition and hydration status. When the nurses were asked to simulate manual flush administration at the same frequency of the automatic device, they were able to meet the recommendations only 10% of the time. CONCLUSION This preliminary study suggests the efficacy of automatic flush systems to prevent enteral tube clogging, without affecting health status compared to standard manual flush systems.
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Tsai MH, Chen YY, Jang TN, Wang JT, Fang YW. Outcome Analysis of Transition From Peritoneal Dialysis to Hemodialysis: A Population-Based Study. Front Med (Lausanne) 2022; 9:876229. [PMID: 35721083 PMCID: PMC9202657 DOI: 10.3389/fmed.2022.876229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
If a technical failure occurs during peritoneal dialysis (PD), the patients undergoing PD may be transitioned to hemodialysis (HD). However, the clinical outcomes of patients who have undergone such a transition are under studied. This study assessed whether patients undergoing HD who have transitioned from PD have the same clinical outcomes as HD-only patients. This research was a retrospective cohort study by searching a National Health Insurance research database for data on patients in Taiwan who had undergone HD between January 2006 and December 2013. The patients were divided into two groups, namely a case group in which the patients were transitioned from PD to HD and a HD-only control group, through propensity score matching at a ratio of 1:4 (n = 1,100 vs. 4,400, respectively). We used the Cox regression model to estimate the hazard ratios (HRs) for all-cause death, all-cause hospitalization, infection-related admission, and major adverse cardiac events (MACE). Those selected patients will be followed until death or the end of the study period (December, 2017), whichever occurs first. Over a mean follow-up of 3.2 years, 1,695 patients (30.8%) died, 3,825 (69.5%) required hospitalization, and 1,142 (20.8%) experienced MACE. Patients transitioning from PD had a higher risk of all-cause death (HR: 1.36; 95% CI: 1.21–1.53) than HD-only patients. However, no significant difference was noted in terms of MACE (HR: 0.91; 95% CI: 0.73–1.12), all-cause hospitalization (HR: 1.07; 95% CI: 0.96–1.18), or infection-related admission (HR: 0.97, 95% CI: 0.80–1.18) between groups. Because of the violation of the proportional hazard assumption, the piecewise-HRs showed that the risk of mortality in the case group was significant within 5 months of the transition (HR: 2.61; 95% CI: 2.04–3.35) not in other partitions of the time axis. In conclusion, patients undergoing HD who transitioned from PD had a higher risk of death than the HD-only patients, especially in the first 5 months after transition (a 161% higher risk). Therefore, more caution and monitoring may be required for patients undergoing HD who transitioned from PD.
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Affiliation(s)
- Ming-Hsien Tsai
- Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Department of Medicine, Fu Jen Catholic University School of Medicine, Taipei, Taiwan
| | - Yun-Yi Chen
- Department of Research, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tsrang-Neng Jang
- Department of Medicine, Fu Jen Catholic University School of Medicine, Taipei, Taiwan.,Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Jing-Tong Wang
- Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Yu-Wei Fang
- Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Department of Medicine, Fu Jen Catholic University School of Medicine, Taipei, Taiwan
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Huppertz V, Guida S, Holdoway A, Strilciuc S, Baijens L, Schols JMGA, van Helvoort A, Lansink M, Muresanu DF. Impaired Nutritional Condition After Stroke From the Hyperacute to the Chronic Phase: A Systematic Review and Meta-Analysis. Front Neurol 2022; 12:780080. [PMID: 35178021 PMCID: PMC8846185 DOI: 10.3389/fneur.2021.780080] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022] Open
Abstract
Background Malnutrition is common after stroke and can affect rehabilitation and healthcare costs. A comprehensive overview of stroke patients' nutritional condition from the hyperacute to the chronic phase is lacking. This systematic review aimed to investigate the prevalence of impaired nutritional condition (INC) across the continuum of care in specific phases after stroke. Methods CAB ABSTRACTS, Embase, MEDLINE, were used to collect studies published between 01-01-1999 and 26-08-2020. Primary and secondary outcomes were prevalence of INC and prevalence of malnutrition, respectively. Exploratory outcomes were prevalence of INC at follow-up, nutritional examination methods, prevalence of dysphagia, stroke severity, adverse events, and continent-specific prevalence of INC. A random-effects meta-analysis model was used to estimate the phase-specific pooled prevalence of INC and malnutrition. Results The dataset consisted of 78 study groups selected over a total of 1,244 identified records. The pooled prevalence of INC and malnutrition were 19% (95%CI:7–31) (N = 4) and 19% (95%CI:9–29) (N = 3), 34% (95%CI:25–43) (N = 34) and 26% (95%CI:18–35) (N = 29), 52% (95%CI:43–61) (N = 34) and 37% (95%CI:28–45) (N = 31), 21% (95%CI:12–31) (N = 3) and 11% (95%CI:0–24) (N = 3) and 72% (95%CI:41–100) (N = 3) and 30% (95%CI:0–76) (N = 2) in the hyperacute, acute, early subacute, late subacute, and chronic phase, respectively. Conclusion INC and malnutrition are highly prevalent in all stages of stroke care. Since malnutrition has been shown to negatively affect clinical outcomes, mortality, and overall healthcare expenditure in stroke survivors, it is essential to examine and monitor the nutritional status of stroke patients throughout their care journey to guide and plan, timely nutritional support and dietary modification.
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Affiliation(s)
- Viviënne Huppertz
- Department of Respiratory Medicine, Maastricht University, Maastricht, Netherlands
- *Correspondence: Viviënne Huppertz
| | - Sonia Guida
- Danone Nutricia Research, Utrecht, Netherlands
| | - Anne Holdoway
- DHealth, Consultant Dietitian, BMI/Circle Bath Clinic, Education Officer for the British Association for Parenteral and Enteral Nutrition and Chair of the UK Managing Adult Malnutrition in the Community Panel, Bath, United Kingdom
| | - Stefan Strilciuc
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Laura Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, and School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Jos M. G. A. Schols
- Department of Health Services Research, Maastricht University, Maastricht, Netherlands
| | - Ardy van Helvoort
- Department of Respiratory Medicine, Maastricht University, Maastricht, Netherlands
- Danone Nutricia Research, Utrecht, Netherlands
| | | | - Dafin F. Muresanu
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- “RoNeuro” Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
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Mahmoudinezhad M, Khalili M, Rezaeemanesh N, Farhoudi M, Eskandarieh S. Subjective global assessment of malnutrition and dysphagia effect on the clinical and Para-clinical outcomes in elderly ischemic stroke patients: a community-based study. BMC Neurol 2021; 21:466. [PMID: 34847871 PMCID: PMC8630876 DOI: 10.1186/s12883-021-02501-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022] Open
Abstract
Background Malnutrition as a result of insufficient intake or uptake of nutrition leads to increasing rate of chronic diseases such as stroke. Stroke is one of the most common causes of death in western countries and its increasing trend has attracted lots of attention. In this regard, it seems logical to focus on modifiable risk factors such as nutrition, in order to reduce the resulting complications. Accordingly, this study aimed at evaluating nutrition status of stroke patients to estimate its relationship with clinical outcomes of stroke. Methods In the present cross-sectional study, 349 patients were recruited. Nutrition assessment was performed using Patient-Generated Subjective Global Assessment (PG-SGA). In addition, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and biochemical tests were performed. Results Our findings elucidated a significant positive correlation of mRS with PG-SGA and consciousness score, as well as a negative correlation with BMI, calf circumference, mid-arm circumference, and triceps skinfold at admission time (P ≤ 0.002). Moreover, a direct correlation was found between mRS and PG-SGA and consciousness score at discharge time (P ≤ 0.001). In contrast, an inverse correlation was established between mRS and mid-arm circumference (P = 0.02). Furthermore, univariate analysis indicated significant associations between mRS ≥ 3 and age (OR: 1.02; 95%CI: 1.00–1.04), PG-SGA (OR: 1.08; 95%CI: 1.03–1.13), NIHSS (OR: 1.04; 95%CI: 1.02–1.07), dysphagia (OR: 1.69; 95%CI: 1.03–2.77), consciousness (OR: 1.48; 95%CI: 1.07–2.04), and mid-arm circumference (OR: 0.95; 95%CI: 0.90–1.00). In addition, these associations remained significant in multivariate analysis for PG-SGA (OR: 1.07; 95%CI: 1.00–1.13) and NIHSS (OR: 1.04; 95%CI: 1.01–1.07). Conclusion This study revealed a positive correlation between mRS and consciousness status and PG-SGA score, as well as a negative one between mRS and MAC at discharge time.
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Affiliation(s)
| | - Mohammad Khalili
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Rezaeemanesh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Farhoudi
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Kim D, Lim H. Association between combinations of nutritional status and quality of life and food purchasing motives among the elderly in South Korea. Health Qual Life Outcomes 2020; 18:186. [PMID: 32546173 PMCID: PMC7298780 DOI: 10.1186/s12955-020-01434-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 06/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background In the elderly, nutritional status and quality of life (QOL) could potentially affect food purchasing behaviors. We examined the association between combinations of nutritional status and QOL and food purchasing motives among the elderly. Methods A total of 143 community-dwelling elderly were recruited in Seoul, South Korea. Nutritional status and QOL were assessed and participants were divided into four groups according to those combinations. Binary logistic regression analysis was used to examine the odds of food purchasing motives according to combinations of nutritional status and QOL. Results As a result of comparing the scores (mean ± SD) of the overall important factors for food purchasing, health related factors such as Nutrition quality and Preventive of treatment effect were the highest score (4.4 ± 0.8), followed by Price (4.1 ± 0.9), Ease of purchase (3.8 ± 0.9), Ease of chewing (3.7 ± 0.9), and Taste (3.6 ± 0.9). Participants with a low nutritional status and low QOL had more eating-related problems (77.8%) including chewing difficulty (48.9%) and constipation (17.8%) than those with a high nutritional status and high QOL (P < 0.05). Participants who were in high nutritional status and low QOL were more likely to be motivated by Ease of chewing (OR: 6.72; 95% CI: 1.44–31.37; P < 0.05), while those who were in low nutritional status and high QOL were less motivated by Taste (OR: 0.28; 95% CI: 0.08–0.94; P < 0.05) compared to those who were in high nutritional status and high QOL. Conclusions There were differences in food purchasing motives such as Ease of chewing or Taste according to combinations of nutritional status and QOL. These data are important in demonstrating differing motives for food choice across nutritional status and QOL, and also provide indications of which care service and food development may be needed in promoting health for the elderly in South Korea.
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Affiliation(s)
- Doyeon Kim
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul, Republic of Korea
| | - Hyunjung Lim
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul, Republic of Korea. .,Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yong-in, Republic of Korea.
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Kim SR, Kim JY, Kim HY, Nho JH, Kim YH, Min SY. Factors related to malnutrition in community-dwelling patients with schizophrenia. Perspect Psychiatr Care 2019; 55:415-423. [PMID: 30430589 DOI: 10.1111/ppc.12327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 09/03/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study aims to identify demographic, clinical, and nutritional factors related to malnutrition in community-dwelling patients with schizophrenia. DESIGN AND METHODS We used a descriptive cross-sectional design. Between June and July 2016, 188 community-dwelling patients with schizophrenia were included in this study. FINDINGS Of the 188 participants, 4.3% were classified as malnourished, and 40.4% were at risk of malnutrition. Living status, body weight, and appetite were significant factors related to malnutrition in community-dwelling patients with schizophrenia. PRACTICE IMPLICATION Assessment of nutritional status should be considered along with demographic and nutritional factors in community-dwelling patients with schizophrenia.
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Affiliation(s)
- Sung Reul Kim
- Department of Nursing, Korea University, Seoul, South Korea
| | - Ji Young Kim
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Hye Young Kim
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Ju-Hee Nho
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Young Hwa Kim
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - So-Young Min
- Department of Nursing, Semyung University, Jecheon, South Korea
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Lin SC, Lin KH, Lee YC, Peng HY, Chiu EC. Test-retest reliability of the Mini Nutritional Assessment and its relationship with quality of life in patients with stroke. PLoS One 2019; 14:e0218749. [PMID: 31220156 PMCID: PMC6586339 DOI: 10.1371/journal.pone.0218749] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/09/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND & OBJECTIVE Malnutrition is one of commonly issues in patients with stroke. The Mini Nutritional Assessment (MNA) is a widely used measure for assessing nutritional status in patients with stroke. A nutritional measure with acceptable test-retest reliability allows clinicians to consistently assess patients' nutritional status. Knowledge of the relationship between nutritional status and quality of life (QOL) could guide clinicians to improve QOL in patients with stroke more effectively. This study aimed to examine test-retest reliability of the MNA and its relationship with QOL in patients with stroke. METHODS Fifty-nine patients participated in the test-retest reliability study and the correlation between the MNA and WHO Quality of Life-BREF (WHOQOL-BREF) study. A repeated-assessments design (1 week apart) was used to examine the test-retest reliability of the MNA. RESULTS The intraclass correlation coefficient for the MNA was 0.91. The minimal detectable change and percentage of minimal detectable change for the MNA were 2.1 and 8.2%, respectively. The MNA was positively associated with the QOL (r = 0.32; p = 0.013). The result of linear regression analysis shows that after controlling for age, sex and activities of daily living functions, only the MNA was significantly associated with the WHOQOL-BREF (r2 = 0.104; p = 0.008). CONCLUSIONS The MNA has satisfactory test-retest reliability that is useful for repeatedly assessing the nutritional status of patients with stroke. The MDC of the MNA has acceptable random measurement error which is useful for determining whether the change score of a patient is outside the range of random measurement error. Future studies that recruit stroke patients in the acute stage is needed to further examine the relationship between the nutritional status and QOL.
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Affiliation(s)
- Shu-Chi Lin
- Department of Nutrition, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Kuan-Hung Lin
- Department of Neurology, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Ya-Chen Lee
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Hsiao-Yun Peng
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
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Aliasghari F, Izadi A, Khalili M, Farhoudi M, Ahmadiyan S, Deljavan R. Impact of Premorbid Malnutrition and Dysphagia on Ischemic Stroke Outcome in Elderly Patients: A Community-Based Study. J Am Coll Nutr 2018; 38:318-326. [DOI: 10.1080/07315724.2018.1510348] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Fereshteh Aliasghari
- Department of Biochemistry and Diet Therapy, School of Nutrition and Food Science, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azimeh Izadi
- Department of Biochemistry and Diet Therapy, School of Nutrition and Food Science, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Khalili
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Farhoudi
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahram Ahmadiyan
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Deljavan
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Kim EK, Lee SK, Choi YH, Tanaka M, Hirotsu K, Kim HC, Lee HK, Jung YS, Amano A. Relationship between chewing ability and cognitive impairment in the rural elderly. Arch Gerontol Geriatr 2017; 70:209-213. [DOI: 10.1016/j.archger.2017.02.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 02/02/2017] [Accepted: 02/02/2017] [Indexed: 11/27/2022]
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Schreiber FS, Becker I, Deckert P, Elsbernd H, Isensee C. Malnutrition and Laboratory Markers in Geriatric Patients. A Comparison of Neurologic-psychiatric, Internal and Trauma Surgical Diseases. J Nutr Health Aging 2016; 20:458-61. [PMID: 26999248 DOI: 10.1007/s12603-015-0575-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES There is minimal information on malnutrition in neurologic-psychiatric patients compared to internal and trauma-surgical patients. The aim of the present study was to explore if there is a correlation of these different disease groups with the nutritional assessment and biochemical markers. DESIGN Cross - sectional study. SETTING AND PARTICIPANTS The study was done in a department of geriatric medicine with subspecialisation in neurologic diseases and stroke unit. 338 patients (m / f = 136 / 202, mean age 81.4 ± 7.3 years) were evaluated. MEASUREMENTS The nutritional status was evaluated by using the short form of the Mini Nutritional Assessment (MNA-SF) and seven biochemical markers (hemoglobin, iron, ferritin, vitamin B 12, folic acid, albumin and cholinesterase) were measured. RESULTS There were 74 (22%) patients with MNA ≤ 7 points (malnutrition), 148 (44%) patients with an MNA 8 - 11 points (risk of malnutrition) and 116 (34%) patients with an MNA ≥ 12 points (good nutritional status). The mean MNA score of the three major disease groups trauma-surgery, internal medicine and neurology-psychiatry was 9.1 ± 3.2 vs. 9.9 ± 3.1 vs. 10.0 ± 2.8 (p=0.236). There were significant differences of laboratory markers between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in trauma-surgical and internal patients than in neurological-psychiatric patients (albumin: 21.4%, 15.7%, 5.3%; p=0.001; cholinesterase 16.7%, 16.9%, 6.3%; p=0.007; hemoglobin 78.6%, 61.4%, 50.0%; p=0.002). CONCLUSIONS Following Mini Nutritional Assessment, the additional measurement of albumin, cholinesterase and hemoglobin allowed a more precise grading of malnutrition. There were significant differences between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in multimorbid trauma-surgical and internal patients than in neurologic-psychiatric patients.
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Affiliation(s)
- F S Schreiber
- Franz Stefan Schreiber M.D. Department of Geriatrics, St. Marien Hospital, Teaching Hospital of the University of Aachen Medical School, Hospitalstrasse 44, 52353 Düren, Germany, Phone: 01149 - 2421 - 805657, Fax: 01149 - 2421 - 8057079,
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Abstract
OBJECTIVE To construct a quickly and easily administered nutrition screening tool using variables believed to be predictive of malnutrition risk in the wound patient population. DESIGN A prospective pilot study assessed patients on a list of suspected variables, as well as the Scored Patient-Generated Subjective Global Assessment (PG-SGA), chosen as the criterion standard. Variables were analyzed to select the most appropriate items for inclusion on a new nutrition screening tool using preliminary bivariate correlations and χ tests of association. Items significantly associated with malnutrition were dichotomized, and binary logistic regression analyses were performed to arrive at a final model. A sum score was computed, and receiver operating characteristic analysis was used to determine designation of risk. SETTING An outpatient wound center in Northeast Ohio. PARTICIPANTS The pilot study included a convenience sample of 105 outpatients with at least 1 active wound. MAIN OUTCOME MEASURES Malnutrition as assessed by the Scored PG-SGA. MAIN RESULTS The final nutrition screening tool, the MEAL Scale, is composed of 4 dichotomous elements: multiple wounds (number of wounds), eats less than 3 meals per day, appetite decrease (eats less than usual), and level of activity. These variables predicted 83.7% of the malnutrition cases assessed by the Scored PG-SGA. The receiver operating characteristic analysis showed an acceptable area under the curve (0.8581), and a cutoff score of 2 or greater was selected to indicate risk (median sensitivity = 91.4%, median specificity = 60.9%). CONCLUSIONS Although further studies of validity and reliability are necessary to establish the tool before widespread use, the MEAL Scale is a needed step toward nutrition screening in a wound patient population.
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Choi SH, Choi-Kwon S, Kim MS, Kim JS. Poor nutrition and alcohol consumption are related to high serum homocysteine level at post-stroke. Nutr Res Pract 2015; 9:503-10. [PMID: 26425280 PMCID: PMC4575963 DOI: 10.4162/nrp.2015.9.5.503] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/30/2015] [Accepted: 06/30/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES Increased serum homocysteine (Hcy) levels have been reported to be related to the occurrence of cardio- and cerebrovascular diseases. High serum Hcy levels are also related to the development of secondary stroke and all-cause mortality. The purpose of this study was to investigate the prevalence of high serum homocysteine level and relating factors, and the change over the 10 month period post-stroke. SUBJECTS/METHODS Consecutive stroke patients who were admitted to the Asan Medical Center were enrolled. Ten months after the onset of stroke, an interview with a structured questionnaire was performed and blood samples were obtained for the biochemical parameters. Nutritional status was determined using the mini nutritional assessment (MNA) score and dietary nutrient intakes were also obtained using a 24 hour recall method. RESULTS Out of 203 patients, 84% were malnourished or at risk of malnutrition, and 26% had high homocysteine levels at 10 months post-stroke. Using logistic regression, the factors related with high homocysteine levels at 10 months post-stroke included heavy alcohol consumption (P = 0.020), low MNA scores (P = 0.026), low serum vitamin B12 (P = 0.021) and low serum folate levels (P = 0.003). Of the 156 patients who had normal homocysteine levels at admission, 36 patients developed hyperhomocysteinemia 10 months post-stroke, which was related to heavy alcohol consumption (P = 0.013). Persistent hyperhomocysteinemia, observed in 22 patients (11%), was related to male sex (P = 0.031), old age (P = 0.042), low vitamin B6 intake (P = 0.029), and heavy alcohol consumption (P = 0.013). CONCLUSION Hyperhomocysteinemia is common in post-stroke, and is related to malnutrition, heavy alcohol drinking and low serum level of folate and vitamin B12. Strategies to prevent or manage high homocysteine levels should consider these factors.
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Affiliation(s)
- Seung-Hye Choi
- Department of Nursing Science, Suwon University, Gyeonggi 447-743, Korea
| | - Smi Choi-Kwon
- College of Nursing & Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongro-Gu, Seoul 110-799, Korea
| | - Min-Sun Kim
- Nutritional Science, Department of Agriculture and Natural Resources, Michigan State University 48109, USA
| | - Jong-Sung Kim
- Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
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14
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Prins A. The nutritional management of a central venous incident. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2015. [DOI: 10.1080/16070658.2015.11734544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Kim SR, Chung SJ, Yoo SH. Factors contributing to malnutrition in patients with Parkinson's disease. Int J Nurs Pract 2014; 22:129-37. [DOI: 10.1111/ijn.12377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Sung R Kim
- College of Nursing; Chonbuk National University; Jeonju Korea
| | - Sun J Chung
- Department of Neurology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Sung-Hee Yoo
- College of Nursing; Chonnam National University; Gwangju Korea
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