Acute stroke patients not meeting their nutrition requirements: Investigating the effect of an enriched environment on nutrition

Abstract

Background: Malnutrition is common after stroke. We investigated nutritional intake and outcomes within a study of enriched environment in an acute stroke unit. Methods: We performed a before-after study. Usual care participants had meals in their room whilst enriched environment participants were provided the opportunity of communal mealtimes. Both groups received nutritional supplementation if indicated. Breakfast and lunch meals were observed and remaining intake calculated using food charts. Nutrition requirements were calculated for total energy (ratio method) and protein (1 g/kg) and proportion of requirements met (%). Malnutrition was assessed using the Subjective Global Assessment and admission and discharge weights. Stepwise multivariable logistic regression was performed to assess predictors of nutritional outcomes, adjusting for intervention group, age, gender, stroke type and severity, length of stay, admission weight, and dietary modification. Results: Neither usual care (n=30, age 76.0±12.8) or enriched environment (n=30, age 76.7±12.1) met daily requirements for energy (70.7%±16.8 vs. 70.7%±17.3, p=0.94) or protein (73.2%±18.6 vs. 69.8%±17.3, p=0.70). Mean weight dropped (0.92 kg usual vs. 0.64 kg enriched) and malnutrition rates increased: usual care (3.3% to 26.6%) and enriched (6.6% to 13.3%). Predictors of malnutrition on discharge in logistic regression models were: length of stay (p<0.01), and protein (P<0.01) or energy intake (p<0.05). Lower rates of malnutrition in the enriched environment group became non-significant when length of stay was included in the model. Conclusion: Overall, acute stroke patients were not meeting nutritional requirements and losing weight. The enriched environment had no effect on nutritional intake.L618235930 <br />