Abstract
Purpose
This study aimed to explore the correlation between nutritional status screening using the MNA-SF and stroke-associated infections (SAI) in older adults.
Methods
A retrospective study of patients aged over 70 years with acute stroke was conducted. The patients were divided into normal nutritional status, malnutrition risk, and malnutrition groups depending on their baseline MNA-SF scores. The correlation between nutritional status and SAI was identified using multivariate logistic regression. The receiver operating characteristic (ROC) curve was used to demonstrate the predicted value of MNA-SF.
Results
497 patients were included, 101 (20.32%) developed SAI. 32.29% of patients with malnutrition developed SAI, while 25.14% of those with malnutrition risk developed SAI. Malnutrition (aOR 4.58, 95% CI 2.34–8.96, p < 0.001) and risk of malnutrition (aOR 3.70, 95%CI 2.01–6.85, p < 0.001) were independent risk factors for SAI in older stroke patients. The area under the curve (AUC) value of MNA-SF was 0.713.
Conclusion
MNA-SF is a simple and effective nutritional screening tool for predicting the occurrence of SAI in older patients with acute stroke.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
References
Wastfelt M, Cao Y, Strom JO (2018) Predictors of post-stroke fever and infections: a systematic review and meta-analysis. BMC Neurol 18:49
Vermeij FH, Scholte op Reimer WJ, de Man P et al (2009) Stroke-associated infection is an independent risk factor for poor outcome after acute ischemic stroke: data from the Netherlands Stroke Survey. Cerebrovasc Dis 27:465–471
Suda S, Aoki J, Shimoyama T et al (2018) Stroke-associated infection independently predicts 3-month poor functional outcome and mortality. J Neurol 265:370–375
Tinker RJ, Smith CJ, Heal C et al (2021) Predictors of mortality and disability in stroke-associated pneumonia. Acta Neurol Belg 121:379–385
Sellier C (2018) Malnutrition in the elderly, screening and treatment. Soins Gerontol 23:12–17
Power L, Mullally D, Gibney ER et al (2018) A review of the validity of malnutrition screening tools used in older adults in community and healthcare settings - a MaNuEL study. Clin Nutr ESPEN 24:1–13
Kellett J, Kyle G, Itsiopoulos C et al (2016) Nutrition screening practices amongst australian residential aged care facilities. J Nutr Health Aging 20:1040–1044
Khanzadeh S, Lucke-Wold B, Eshghyar F et al (2022) The neutrophil to lymphocyte ratio in poststroke infection: a systematic review and meta-analysis. Dis Markers 2022:1983455
Horan TC, Gaynes RP, Martone WJ et al (1992) CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 13:606–608
Smith CJ, Kishore AK, Vail A et al (2015) Diagnosis of stroke-associated pneumonia: recommendations from the pneumonia in stroke consensus group. Stroke 46:2335–2340
Lan Y, Sun W, Chen Y et al (2020) Nomogram including neutrophil-to-lymphocyte ratio for the prediction of stroke-associated infections. Front Neurol 11:574280
Westendorp WF, Vermeij JD, Zock E et al (2015) The Preventive Antibiotics in Stroke Study (PASS): a pragmatic randomised open-label masked endpoint clinical trial. Lancet 385:1519–1526
Rubenstein LZ, Harker JO, Salva A et al (2001) Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J GerontolA Biol Sci Med Sci 56:M366-372
Maruyama K, Nakagawa N, Koyama S et al (2018) Malnutrition increases the incidence of death, cardiovascular events, and infections in patients with stroke after rehabilitation. J Stroke Cerebrovasc Dis 27:716–723
Scrutinio D, Lanzillo B, Guida P et al (2020) Association between malnutrition and outcomes in patients with severe ischemic stroke undergoing rehabilitation. Arch Phys Med Rehabil 101:852–860
Alwarawrah Y, Kiernan K, MacIver NJ (2018) Changes in nutritional status impact immune cell metabolism and function. Front Immunol 9:1055
Nam KW, Kim TJ, Lee JS et al (2018) High neutrophil-to-lymphocyte ratio predicts stroke-associated pneumonia. Stroke 49:1886–1892
Acknowledgements
We would like to thank Editage (www.editage.cn) for English language editing.
Funding
This work was supported by Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University (2021-LCYJ-PY-22) to Shuangshuang Gu and Project of Medical and Technological Development Program of Nanjing (YKK21091) to Guofeng Fan.
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Contributions
YZ and JL: data acquisition, data analysis, data interpretation, draft the early version of the manuscript. SG: conception and design of the work, critical review of the manuscript. GF and FG: data acquisition and data analysis. JW: critical review of the manuscript.
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The authors declare that there are no conflicts of interest.
Ethical approval
This study was performed in line with the principles of the Declaration of Helsinki, and was approved by the Ethics Committee of Nanjing Drum Tower Hospital (2021-407-02).
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The need for individual patient consent was waived.
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Zhou, Y., Li, J., Fan, G. et al. Correlation between nutritional status screening by MNA-SF and acute stroke-associated infections in older adults. Aging Clin Exp Res 35, 717–721 (2023). https://doi.org/10.1007/s40520-022-02334-2
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DOI: https://doi.org/10.1007/s40520-022-02334-2