High Nutritional-Related Risk on Admission Predicts Less Improvement of Functional Independence Measure in Geriatric Stroke Patients: A Retrospective Cohort Study

Abstract

Background: The aim of the present study was to establish whether high nutritional-related risk on admission predicts less improvement of Functional Independence Measure (FIM) in geriatric stroke patients.

Methods: We performed a retrospective cohort study of patients admitted for stroke at 5 major hospitals in the Noto district of Japan from July 2009 to June 2013. Patients were divided into 2 groups according to Geriatric Nutritional Risk Index (GNRI) at admission. Patient characteristics were compared between the low GNRI (<92) and high GNRI (≥92) groups. We assessed nutritional status using GNRI and activities of daily living using the FIM.

Results: A total of 540 participants (mean age, 80 years; interquartile range, 75-85 years) were included in the present study. Patients were admitted because of cerebral infarction (394 patients), intracerebral hemorrhage (123 patients), and subarachnoid hemorrhage (23 patients). Univariate analysis of FIM gain demonstrated significant differences between groups. Multivariate analysis of FIM gain adjusting for confounding factors demonstrated age (β = -.139; 95% confidence interval [CI] = -.629 to -.140), cerebral infarction (β = -.264; 95% CI = -12.956 to -6.729), National Institutes of Health Stroke Scale (β = -.180; 95% CI = -.688 to -.248), and GNRI score (β = .089; 95% CI = .010-.347) as independent factors associated with FIM gain (P < .05 for all).

Conclusions: GNRI at admission may independently predict FIM gain. Poor nutritional status is a predictor of lower FIM improvement in geriatric stroke patients.

Keywords: Functional Independence Measure; Geriatric Nutritional Risk Index; Nutritional status; activities of daily living; stroke.