From the Research
Approximately 72% of patients with severe stroke require nutritional follow-up in the chronic phase of stroke, as indicated by the high prevalence of impaired nutritional condition in this phase. This follow-up is essential as malnutrition remains a significant concern even after the acute phase has passed, with studies showing that malnutrition can negatively affect clinical outcomes, mortality, and overall healthcare expenditure in stroke survivors 1. Patients with severe strokes often experience persistent dysphagia (swallowing difficulties), reduced mobility, cognitive impairments, and depression, all of which can negatively impact nutritional intake and status.
Key Considerations for Nutritional Follow-up
- Regular assessments of nutritional status using tools like the Mini Nutritional Assessment (MNA)
- Monitoring of weight changes and evaluation of dietary intake
- Interventions may include dietary modifications, oral nutritional supplements, enteral nutrition via feeding tubes for those with persistent severe dysphagia, and addressing specific nutrient deficiencies
- The frequency of follow-up depends on the individual's condition but generally occurs every 1-3 months initially, then every 3-6 months as the patient stabilizes
Importance of Early Identification and Management
Early identification and management of nutritional problems in the chronic phase can prevent complications like pressure ulcers, infections, and functional decline, ultimately improving rehabilitation outcomes and quality of life. The use of enteral nutrition support has been shown to be a useful method of providing nutrition for patients with dysphagia following a stroke, enhancing their nutritional status and promoting their health 2. However, it is crucial to consider the individual patient's needs and tailor the nutritional support accordingly, taking into account factors such as the presence of dysphagia, decreased level of consciousness, and the need for long-term enteral nutrition support 3.