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PTU-114 The role of malnutrition universal screening tool (must) in determining risk of malnutrition and predicting clinical outcome in patients after a stroke
  1. Y Kama1,
  2. S Burden1,
  3. S Lal1,
  4. C Smith2,
  5. S Hamdy1
  1. 1GI Sciences, School of Medical Sciences, The University of Manchester, Manchester
  2. 2Stroke Services, Salford Royal Hospital NHS Trust, Salford, UK

Abstract

Introduction Malnutrition has become a paramount residual disability that is commonly seen in patients after a stroke. In addition, malnutrition is associated with poor clinical outcome in these people (1, 2). Several published studies have reported that the prevalence of malnutrition in these patients varies widely from 6.1%–62% (3). This study aimed to establish the true prevalence of malnutrition is among patients after a stroke and whether the malnutrition universal screening tool (MUST) can be used as an independent predictor of clinical outcome in stroke victims.

Method This is a retrospective observational cohort study using patients‘ records who have been admitted to stroke unit at a large teaching hospital in the North West of England, and who have had MUST as part of routine care from January 2013 to March 2016. The cohort data utilised information obtained from the Sentinel Stroke National Audit Programme (SSNAP).

Results Of 1101 patients, 51% were women, the mean age of 73.6 years, and 88.7% had an ischaemic stroke. Of these, while the majority of patients (78.5%,n=571 ) had no risk of malnutrition, 17.3% (n=126) had high risk, and 4.1% (n=30) had medium risk. Additionally, the association between risk of malnutrition and clinical outcomes was both significant and proportional (i.e. the greater the risk of malnutrition the higher the possibility of poorer outcomes). For those who had greater risk of malnutrition (high vs. medium), their hospital stay was longer (p≤0.023 vs. p≤0.033). In the high risk group, mortality was higher both within the hospital admission (Pć 0.001), and at 6 months follow-up (Pć0.001) and infections more prevalent (Pć 0.001).

Conclusion Malnutrition is prevalent in the stroke population. Furthermore, the application of the MUST as an independent predictor of clinical outcomes can be used in health care settings with reference to acute stroke. Therefore early identification of risk of malnutrition in stroke and future provision of early nutritional interventions is likely to become an important priority for the health services in the UK with potential improved clinical outcomes and resources saving.

References

  1. . Chai J, et al., Singapore Med J. 2008;49(4):290–6

  2. . Choi-Kwon S, et al., Acta Neurol Scand. 1998;98(3):187–192.

  3. . Foley N, et al., Stroke. 2009;40 (3): e66–e74.

Disclosure of Interest None Declared

  • length of hospital stay
  • malnutrition
  • mortality
  • MUST
  • post-stroke complication
  • stroke

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