Stroke Clinical Trial
Official title:
Nutritional Therapy for Patients With Acute Stroke and With Poor Nutritional Status or at Risk of Poor Nutritional Status
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.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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