Analyses of an appropriate nutritional status index for predicting outcome and effects of nutritional intervention for patients with acute stroke

2022 Fiscal Year Final Research Report

• Project/Area Number: 21K17692
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 59040:Nutrition science and health science-related
• Research Institution: Nihon University
• Principal Investigator: AKIMOTO Takayoshi 日本大学, 医学部, 助教 (20896948)
• Project Period (FY): 2021-04-01 – 2023-03-31
• Keywords: 脳卒中 / 脳梗塞 / フレイル / 栄養 / サルコペニア / 肺炎

Outline of Final Research Achievements

Undernutrition, frailty, and sarcopenia are each associated and, along with stroke, are implicated in death and care requirements in the elderly. I developed a database of acute ischemic stroke (AIS) inpatients with stroke severity, comorbidities, disease type, nutritional assessment, frailty, and sarcopenia. Complications of frailty were found in 27.8% of patients admitted with AIS, suggesting that frailty is a factor that worsens AIS outcomes. I also analyzed post-stroke pneumonia (PSP), and found that it was difficult to identify the organism causing PSP, what antimicrobial agents were administered for PSP, and that complications of PSP were associated with poorer outcomes.

Free Research Field

神経内科学

Academic Significance and Societal Importance of the Research Achievements

低栄養、フレイル、サルコペニアはそれぞれ関連があり脳卒中と並んで高齢者における死亡や要介護状態に関与している。近年、AIS診療においては血栓溶解療法や血栓回収療法といった超急性期治療への注目度が高いが、本研究結果からはAIS患者においてフレイルの存在を認識することの重要性が強調された。フレイル対策として栄養療法が強調されているが、AIS患者の栄養状態の評価を行い、栄養状態を改善させることが転帰を改善させるかは今後の課題である。また、PSPは低栄養患者に併発しやすいが、実臨床でどのような治療が行われたかを明らかとし、AISに合併するPSPの転帰を改善させる上で有用な知見が明らかとなった。