From the Guidelines
Approximately 40% of patients with minor stroke require nutritional follow-up in the chronic phase of stroke, as supported by the most recent evidence from 2021 1. This need for nutritional monitoring persists even when initial deficits appear mild, as patients with minor strokes often develop subtle swallowing difficulties, weight loss, or nutritional deficiencies that may go undetected without proper assessment. Some key points to consider in the management of these patients include:
- A comprehensive nutritional evaluation should be conducted at regular intervals, including assessment of body weight, BMI, protein status, and micronutrient levels.
- Early identification of nutritional issues can prevent complications like sarcopenia, impaired wound healing, and compromised immune function, which may otherwise hinder recovery and increase the risk of recurrent stroke.
- Nutritional intervention may include dietary counseling, oral nutritional supplements, or referral to a dietitian depending on the severity of nutritional compromise, as recommended by the ESPEN guideline on clinical nutrition in neurology 1.
- The importance of early dysphagia screening and management is also highlighted in the guidelines for adult stroke rehabilitation and recovery 1, which can help reduce the risk of pneumonia, malnutrition, and other adverse health consequences.
- It is essential to note that the prevalence of malnutrition in stroke patients can range from 6.1% to 62%, and early nutrition may significantly decrease the risk of death after stroke, as stated in the care of the patient with acute ischemic stroke update 1.
From the Research
Nutritional Follow-up in Minor Stroke Patients
- The provided studies do not directly address the percentage of patients with minor stroke who require nutritional follow-up in the chronic phase of stroke 2, 3, 4, 5, 6.
- However, the studies highlight the importance of nutritional interventions in stroke patients, particularly those with dysphagia, to prevent malnutrition and improve outcomes 2, 3, 4.
- Malnutrition is common in stroke patients and is associated with poor prognosis, increased mortality, and deteriorated outcomes 3, 4, 5.
- Nutritional screening and assessment are crucial in identifying patients at risk of malnutrition, and various tools and procedures have been used to evaluate nutritional risk in stroke patients 5.
- The use of enteral nutrition support has been shown to be effective in providing nutrition for patients with dysphagia following a stroke, although challenges exist in its implementation 4.
- A recent systematic review found that oral energy and protein supplements may improve activities of daily living (ADL) in stroke patients, but the evidence is very uncertain 6.
- Further research is needed to determine the effectiveness of nutritional therapy in reducing disability and improving ADL in people after stroke, particularly in the chronic phase 6.