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London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 337 107 Stroke prognosis MALNUTRITION IN STROKE PATIENTS DETERMINE POOR OUTCOME M. Santamaría-Cadavid1, J. Montero2, S. Arias-Rivas3, M. Rodríguez-Yáñez4, T. Sobrino5, J. Cas-tillo6, M. Blanco7 Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Uni-versitario, IDIS,, Santiago de Compostela, SPAIN1, Servicio de Clínica Médica. Hospital Pro-vincial del Centenario. Universidad Nacional de Rosario., Rosario, ARGENTINA2, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN3, Department of Neurology, Clinical Neurosciences Research Lab-oratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN4, Department of Neu-rology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN5, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN6, Department of Neurolo-gy, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN7 Introduction: The prevalence of malnutrition (MN) in patients with stroke is frequent (6- 68%). The variability in prevalence and the influence on prognosis is not well known. Our objective is to analyze the correlation between MN prior to stroke and functional outcome at 3 months. Methods: This prospective study included all patients with ischemic stroke (≤24 hours stroke onset) and who met the previously defined inclusion/exclusion criteria. Mini Nutritional Assessment (MNA) was applied by the same blinded physician (24-48h post-admission). Epidemiological, clinical, biochem-ical and prognostic variables were evaluated. Malnutrition-risk (MNR) was defined as MNA 17-24 and malnutrition (MN) as MNA<17. mRS≥3 (90 days) was considered Poor Outcome (PO). Results: Were evaluated 434 patients from July 2011 to March 2012. One hundred and two (23.5%) were el-igible for the study. MN was observed in 14 (13,73%) patients and MNR in 39(38,24%). MNR and MN-patients were analyzed together since no patients with MN showed good outcome. PO patients showed higher MNR-MN percentage (65.1% vs 29.6%, p<0.0001). In the logistic regression model MNR-MN is associated with PO (OR 6.06 1.2-30.1) after adjust by age, NIHSS admission, pres-ence of atrial fibrillation, lymphocyte number, cholesterol and protein levels. Conclusion: More than half of patients admitted with ischemic stroke have MN or MNR. This increases up to 6 times the risk of poor outcome at 3 months. 108 Stroke prognosis What is the outcome of stroke patients with Percutaneous Endoscopic Gastrostomy (PEG) feeding tubes? K. Thavanesan1, O.J David2, S.D. McLaughlin3 Royal Bournemouth and Christchurch Foundation Trust, Bournemouth, UNITED KING-DOM1, Royal Bournemouth and Christchurch Foundation Trust, Bournemouth, UNITED KING-DOM2, Royal Bournemouth and Christchurch Foundation Trust, Bournemouth, UNITED KING-DOM3 Background Dysphagia affects up to 65% of patients being admitted with a stroke, leading to placement of a PEG tube for nutritional support. We undertook a review of all stroke patients during a period of 7.5 years who received a PEG feeding tube. We closely looked at the outcome of the PEG placement, the timing of placement and the one year mortality. Methods A retrospective assessment of all stroke patients receiving a PEG feeding tube between the years of Jan 2005 and September 2012.The data was obtained from our local endoscopy procedural data-base and the clinical data department. As a district general hospital the average presentations of new strokes per year is approximated to 600 patients. Results A total of 130 patients had a PEG tube placed during this time of which 20 patients (15%) had the feeding tube removed within a year following insertion. The average time to removal was between 3-4 months (Range 6 weeks to 9.5 months). It was found that of the 130 stroke patients with a PEG tube in-situ 43 patients (33%) had died at one year and further 72 patients (55%) had died within 5 years with a mean survival of 6.6 months (Range 2 days to 4.7 years). The time taken for PEG tube placement was on average 4 weeks following admission with a stroke. Conclusion These findings remind us that late recovery of swallow can occur following a stroke and patients should have their swallow formally re-assessed, as part of their 6 month stroke follow up (2012 Royal College of Physicians stroke guidelines). Our data suggests that there is a cohort of patients with PEG tubes in-situ who may not require longer term percutaneous tube feeding and would most likely benefit from re-assessment. These results further confirm that more than 50% of patients sur-vive past one year supporting the theory that direct admissions to specialist stroke units does im-prove prognosis and may lead to patients needing longer term multidisciplinary follow up in the future.


Karger_ESC London_2013
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