Se. Gariballa et Aj. Sinclair, ASSESSMENT AND TREATMENT OF NUTRITIONAL-STATUS IN STROKE PATIENTS, Postgraduate medical journal, 74(873), 1998, pp. 395-399
Stroke illness imposes a heavy and costly work load on hospital and co
mmunity care services, and life after stroke can be a miserable affair
for stroke patients and their carers. Nutritional factors may have an
important role in acute stroke and its outcome. From the Limited amou
nt of research undertaken it has been shown that a significant number
of patients with stroke are undernourished on admission and their nutr
itional status deteriorates further as an in-patient. This is especial
ly so for those who are most dependent, in whom undernutrition is also
associated with increasing morbidity and mortality. There is some evi
dence that nutritional supplementation may improve nutritional status
and reduce morbidity and mortality. However most clinically available
nutrition screening instruments lack sensitivity and specificity, and
abnormal nutritional indicators may simply reflect effects of age, fun
ctional disability, or severe underlying disease. Therefore, causal re
lationship cannot be assumed without a sufficiently powerful intervent
ion study which adequately adjusts for the effects of non-nutritional
factors, such as the number and severity of comorbid conditions on cli
nical outcome. Meanwhile, doctors, nurses and members of the multidisc
iplinary team looking after stroke patients should be made aware of th
e likely impact of poor nutritional status on clinical outcome.