Frequent and personalized nutritional support leads to improved nutritional status, activities of daily living, and dysphagia after stroke
•A median of five dietary prescriptions per patient were issued during the 3 mo of in-hospital convalescent rehabilitation after stroke.•The most frequently issued prescription was “diet texture modification,” followed by “energy and protein fortification”.•The frequency of the dietary prescriptions...
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| Veröffentlicht in: | Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2021-03, Vol.83, p.111091-111091, Article 111091 |
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| creator | Shimazu, Sayuri Yoshimura, Yoshihiro Kudo, Mai Nagano, Fumihiko Bise, Takahiro Shiraishi, Ai Sunahara, Takako |
| description | •A median of five dietary prescriptions per patient were issued during the 3 mo of in-hospital convalescent rehabilitation after stroke.•The most frequently issued prescription was “diet texture modification,” followed by “energy and protein fortification”.•The frequency of the dietary prescriptions was independently associated with improved nutritional status, physical function, and dysphagia and shorter hospital stay after stroke.
Evidence for appropriate nutritional assessment, energy prediction, and adaptation and their effect on outcomes after stroke is scarce. We sought to determine the frequency of individualized dietary prescriptions issued for individuals undergoing rehabilitation after stroke and to analyze the effect of diet-prescription frequency on outcomes after stroke.
This single-center prospective cohort study included poststroke patients newly admitted to convalescent rehabilitation wards. The frequency and content of dietary prescriptions issued as part of nutritional assessments were examined. Study outcomes were nutritional status assessed using changes in skeletal muscle mass, physical function assessed using the Functional Independence Measure motor score, dysphagia status assessed using the Food Intake LEVEL Scale (score < 7), and length of hospital stay. Multivariate analyses were performed to determine whether the frequency of dietary prescriptions issued during hospitalization was independently associated with outcomes of interest, after adjusting for potential confounders.
A total of 454 participants (mean age = 71.8 y; 53.1% men, 46.9% women) were included in the final analysis data set. A median of five (range, 2–11) dietary prescriptions were issued per participant during the median 96 d of hospitalization, with the most common items being diet-texture modification for dysphagia and oral energy/protein enhancement. In multivariate analyses, the frequency of dietary prescriptions was independently associated with the change in skeletal muscle mass (β = 0.165, P = 0.028), Functional Independence Measure motor scores at discharge (β = 0.104, P = 0.045), length of stay (β = −0.056, P = 0.019), and presence of dysphagia at discharge (odds ratio = 0.949, P = 0.032).
Frequent and individualized nutritional support is associated with improved nutritional status, physical function, and dysphagia after stroke. Intensive nutritional support through multidisciplinary discussion plays a central role in the prevention and management of mal |
| doi_str_mv | 10.1016/j.nut.2020.111091 |
| format | Article |
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Evidence for appropriate nutritional assessment, energy prediction, and adaptation and their effect on outcomes after stroke is scarce. We sought to determine the frequency of individualized dietary prescriptions issued for individuals undergoing rehabilitation after stroke and to analyze the effect of diet-prescription frequency on outcomes after stroke.
This single-center prospective cohort study included poststroke patients newly admitted to convalescent rehabilitation wards. The frequency and content of dietary prescriptions issued as part of nutritional assessments were examined. Study outcomes were nutritional status assessed using changes in skeletal muscle mass, physical function assessed using the Functional Independence Measure motor score, dysphagia status assessed using the Food Intake LEVEL Scale (score < 7), and length of hospital stay. Multivariate analyses were performed to determine whether the frequency of dietary prescriptions issued during hospitalization was independently associated with outcomes of interest, after adjusting for potential confounders.
A total of 454 participants (mean age = 71.8 y; 53.1% men, 46.9% women) were included in the final analysis data set. A median of five (range, 2–11) dietary prescriptions were issued per participant during the median 96 d of hospitalization, with the most common items being diet-texture modification for dysphagia and oral energy/protein enhancement. In multivariate analyses, the frequency of dietary prescriptions was independently associated with the change in skeletal muscle mass (β = 0.165, P = 0.028), Functional Independence Measure motor scores at discharge (β = 0.104, P = 0.045), length of stay (β = −0.056, P = 0.019), and presence of dysphagia at discharge (odds ratio = 0.949, P = 0.032).
Frequent and individualized nutritional support is associated with improved nutritional status, physical function, and dysphagia after stroke. Intensive nutritional support through multidisciplinary discussion plays a central role in the prevention and management of malnutrition to maximize the improvement of patient outcomes. This study is the first to report this association.</description><identifier>ISSN: 0899-9007</identifier><identifier>EISSN: 1873-1244</identifier><identifier>DOI: 10.1016/j.nut.2020.111091</identifier><identifier>PMID: 33388653</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Activities of daily living ; Body mass index ; Clinical outcomes ; Collaboration ; Diet ; Dietary prescription ; Dietitians ; Dysphagia ; Energy ; Exercise ; Food intake ; Frequency analysis ; Hospitalization ; Hospitals ; Malnutrition ; Meals ; Multivariate analysis ; Muscles ; Musculoskeletal system ; Nurses ; Nutrition assessment ; Nutrition research ; Nutritional status ; Nutritional support ; Patients ; Prescriptions ; Proteins ; Rehabilitation ; Sarcopenia ; Skeletal muscle ; Stroke ; Therapists</subject><ispartof>Nutrition (Burbank, Los Angeles County, Calif.), 2021-03, Vol.83, p.111091-111091, Article 111091</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-afbeb15017d66433f5833c754577cb2eec40cbfb442865484905ab062af3d5c63</citedby><cites>FETCH-LOGICAL-c447t-afbeb15017d66433f5833c754577cb2eec40cbfb442865484905ab062af3d5c63</cites><orcidid>0000-0001-7545-4179</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0899900720303749$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33388653$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shimazu, Sayuri</creatorcontrib><creatorcontrib>Yoshimura, Yoshihiro</creatorcontrib><creatorcontrib>Kudo, Mai</creatorcontrib><creatorcontrib>Nagano, Fumihiko</creatorcontrib><creatorcontrib>Bise, Takahiro</creatorcontrib><creatorcontrib>Shiraishi, Ai</creatorcontrib><creatorcontrib>Sunahara, Takako</creatorcontrib><title>Frequent and personalized nutritional support leads to improved nutritional status, activities of daily living, and dysphagia after stroke</title><title>Nutrition (Burbank, Los Angeles County, Calif.)</title><addtitle>Nutrition</addtitle><description>•A median of five dietary prescriptions per patient were issued during the 3 mo of in-hospital convalescent rehabilitation after stroke.•The most frequently issued prescription was “diet texture modification,” followed by “energy and protein fortification”.•The frequency of the dietary prescriptions was independently associated with improved nutritional status, physical function, and dysphagia and shorter hospital stay after stroke.
Evidence for appropriate nutritional assessment, energy prediction, and adaptation and their effect on outcomes after stroke is scarce. We sought to determine the frequency of individualized dietary prescriptions issued for individuals undergoing rehabilitation after stroke and to analyze the effect of diet-prescription frequency on outcomes after stroke.
This single-center prospective cohort study included poststroke patients newly admitted to convalescent rehabilitation wards. The frequency and content of dietary prescriptions issued as part of nutritional assessments were examined. Study outcomes were nutritional status assessed using changes in skeletal muscle mass, physical function assessed using the Functional Independence Measure motor score, dysphagia status assessed using the Food Intake LEVEL Scale (score < 7), and length of hospital stay. Multivariate analyses were performed to determine whether the frequency of dietary prescriptions issued during hospitalization was independently associated with outcomes of interest, after adjusting for potential confounders.
A total of 454 participants (mean age = 71.8 y; 53.1% men, 46.9% women) were included in the final analysis data set. A median of five (range, 2–11) dietary prescriptions were issued per participant during the median 96 d of hospitalization, with the most common items being diet-texture modification for dysphagia and oral energy/protein enhancement. In multivariate analyses, the frequency of dietary prescriptions was independently associated with the change in skeletal muscle mass (β = 0.165, P = 0.028), Functional Independence Measure motor scores at discharge (β = 0.104, P = 0.045), length of stay (β = −0.056, P = 0.019), and presence of dysphagia at discharge (odds ratio = 0.949, P = 0.032).
Frequent and individualized nutritional support is associated with improved nutritional status, physical function, and dysphagia after stroke. Intensive nutritional support through multidisciplinary discussion plays a central role in the prevention and management of malnutrition to maximize the improvement of patient outcomes. This study is the first to report this association.</description><subject>Activities of daily living</subject><subject>Body mass index</subject><subject>Clinical outcomes</subject><subject>Collaboration</subject><subject>Diet</subject><subject>Dietary prescription</subject><subject>Dietitians</subject><subject>Dysphagia</subject><subject>Energy</subject><subject>Exercise</subject><subject>Food intake</subject><subject>Frequency analysis</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Malnutrition</subject><subject>Meals</subject><subject>Multivariate analysis</subject><subject>Muscles</subject><subject>Musculoskeletal system</subject><subject>Nurses</subject><subject>Nutrition assessment</subject><subject>Nutrition research</subject><subject>Nutritional status</subject><subject>Nutritional support</subject><subject>Patients</subject><subject>Prescriptions</subject><subject>Proteins</subject><subject>Rehabilitation</subject><subject>Sarcopenia</subject><subject>Skeletal 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County, Calif.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shimazu, Sayuri</au><au>Yoshimura, Yoshihiro</au><au>Kudo, Mai</au><au>Nagano, Fumihiko</au><au>Bise, Takahiro</au><au>Shiraishi, Ai</au><au>Sunahara, Takako</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequent and personalized nutritional support leads to improved nutritional status, activities of daily living, and dysphagia after stroke</atitle><jtitle>Nutrition (Burbank, Los Angeles County, Calif.)</jtitle><addtitle>Nutrition</addtitle><date>2021-03</date><risdate>2021</risdate><volume>83</volume><spage>111091</spage><epage>111091</epage><pages>111091-111091</pages><artnum>111091</artnum><issn>0899-9007</issn><eissn>1873-1244</eissn><abstract>•A median of five dietary prescriptions per patient were issued during the 3 mo of in-hospital convalescent rehabilitation after stroke.•The most frequently issued prescription was “diet texture modification,” followed by “energy and protein fortification”.•The frequency of the dietary prescriptions was independently associated with improved nutritional status, physical function, and dysphagia and shorter hospital stay after stroke.
Evidence for appropriate nutritional assessment, energy prediction, and adaptation and their effect on outcomes after stroke is scarce. We sought to determine the frequency of individualized dietary prescriptions issued for individuals undergoing rehabilitation after stroke and to analyze the effect of diet-prescription frequency on outcomes after stroke.
This single-center prospective cohort study included poststroke patients newly admitted to convalescent rehabilitation wards. The frequency and content of dietary prescriptions issued as part of nutritional assessments were examined. Study outcomes were nutritional status assessed using changes in skeletal muscle mass, physical function assessed using the Functional Independence Measure motor score, dysphagia status assessed using the Food Intake LEVEL Scale (score < 7), and length of hospital stay. Multivariate analyses were performed to determine whether the frequency of dietary prescriptions issued during hospitalization was independently associated with outcomes of interest, after adjusting for potential confounders.
A total of 454 participants (mean age = 71.8 y; 53.1% men, 46.9% women) were included in the final analysis data set. A median of five (range, 2–11) dietary prescriptions were issued per participant during the median 96 d of hospitalization, with the most common items being diet-texture modification for dysphagia and oral energy/protein enhancement. In multivariate analyses, the frequency of dietary prescriptions was independently associated with the change in skeletal muscle mass (β = 0.165, P = 0.028), Functional Independence Measure motor scores at discharge (β = 0.104, P = 0.045), length of stay (β = −0.056, P = 0.019), and presence of dysphagia at discharge (odds ratio = 0.949, P = 0.032).
Frequent and individualized nutritional support is associated with improved nutritional status, physical function, and dysphagia after stroke. Intensive nutritional support through multidisciplinary discussion plays a central role in the prevention and management of malnutrition to maximize the improvement of patient outcomes. This study is the first to report this association.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33388653</pmid><doi>10.1016/j.nut.2020.111091</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-7545-4179</orcidid></addata></record> |
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| ispartof | Nutrition (Burbank, Los Angeles County, Calif.), 2021-03, Vol.83, p.111091-111091, Article 111091 |
| issn | 0899-9007 1873-1244 |
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| source | Elsevier ScienceDirect Journals |
| subjects | Activities of daily living Body mass index Clinical outcomes Collaboration Diet Dietary prescription Dietitians Dysphagia Energy Exercise Food intake Frequency analysis Hospitalization Hospitals Malnutrition Meals Multivariate analysis Muscles Musculoskeletal system Nurses Nutrition assessment Nutrition research Nutritional status Nutritional support Patients Prescriptions Proteins Rehabilitation Sarcopenia Skeletal muscle Stroke Therapists |
| title | Frequent and personalized nutritional support leads to improved nutritional status, activities of daily living, and dysphagia after stroke |
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