Nutritional Therapy for Stroke Patients
Nutritional Therapy for Stroke Patients
Prospective, short-term studies in patients admitted for acute stroke have shown an increased
 risk of infections, bedsores, impaired functional outcome, slower rate of recovery, poorer
 rehabilitation potential and higher mortality in patients with a poor nutritional status. In
 hospitals without routine nutritional assessment and individual nutrition management plans,
 the risk of patients developing malnutrition may be increased. In this study, patients
 admitted for acute stroke are randomised into either receiving nutritional therapy derived
 from estimated individual nutritional intake and nutritional needs, or nutritional therapy
 based on routine care without routine assessment of nutritional status, intake, or needs. The
 primary outcome measure is the percentage of patients with weight loss ≥ 5 % at three month
 follow-up.
Prospective, short-term studies in patients admitted for acute stroke have shown an increased
 risk of infections, bedsores, impaired functional outcome, slower rate of recovery, poorer
 rehabilitation potential and higher mortality in patients with a poor nutritional status.
 Sixteen percent of stroke patients are already malnourished on admission to hospital. The
 incidence of dysphagia in patients with acute stroke ranges from 30 to 45%. Dysphagia
 increases the risk of developing poor nutritional status, and new cases of malnutrition
 develop during the hospital stay, even during the first week. In hospitals without routine
 nutritional assessment and individual nutrition management plans, the risk of patients
 developing malnutrition may be increased. In this study patients admitted for acute stroke
 are randomised into either receiving nutritional therapy derived from estimated individual
 nutritional intake and nutritional needs, or nutritional therapy based on routine care;
 without routine assessment of nutritional status, intake or needs. Nutritional therapy:
 enriched meals, sip-feedings or enteral feedings. Parameters of nutritional status: Weight,
 BMI, TSF thickness, mid upper arm circumference, body composition, s-albumin and
 s-transferrin. Estimation of nutritional intake: Daily registration of food and drink intake.
 Estimating functional status: Hand grip strength, Barthels ADL index and Scandinavian stroke
 scale. Estimating quality of life: EQ-5D.

 Before the inclusion started we decided to use the percentage of patients with weight loss ≥
 5 % at 3 months follow-up as the primary outcome measure because this is correlated better to
 clinical outcomes as e.g. mortality and comorbidity. Secondary outcome measures were then
 defined as handgrip strength, quality of life, nutritional status, nutrient intake and length
 of hospital stay.
Inclusion Criteria:

 -  Acute stroke based on clinical symptoms

 -  18 years old and above

 -  < 7 days since debut of stroke symptoms and either body mass index (BMI) = or < 20

 -  Weight loss > 5% in 3-6 months or there has been little or is likely to be no or very
 little nutritional intake for > 5 days

 Exclusion Criteria:

 -  Subarachnoidal bleeding and planned operation

 -  Severe dementia

 -  Reduced consciousness

 -  Immobility

 -  Expected short-time survival