Fluid and energy intake in stroke patients during acute hospitalization in a stroke unit. (April 2019)

• Record Type: Journal Article
• Authors: Buoite Stella, Alex; Gaio, Marina; Furlanis, Giovanni; Douglas, Pauline; Naccarato, Marcello; Manganotti, Paolo
• Is Part Of: Journal of clinical neuroscience. Volume 62(2019)
• Page Start: 27
• Page End: 32
• Publication Date: 2019-04
• Subjects: Hydration -- Fluid intake -- Nutrition -- Energy intake -- Acute stroke -- Stroke unit; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2019.01.016
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Risk of dehydration and malnutrition is common during hospitalization. Despite fluid therapy, hydration status may not improve during acute hospitalization. Fluid volume coming from oral sources predicts hydration status at discharge. Including enteral and parenteral fluids may not predict hydration status at discharge. Abstract: Proper hydration and nutrition have been found to be contributing factors to a better recovery in patients after stroke. A better knowledge of factors influencing fluid and energy intake may contribute to a better care of the acute stroke patient. Aim of this study was to describe hydration status, fluid intake, and energy intake of stroke patients during acute hospitalization in a stroke unit. A retrospective descriptive study was conducted in stroke patients admitted to a stroke unit. All patients received neurological evaluation and urinary osmolality (uOsm) measure at admission and discharge. During stroke unit stay patients received a day-by-day diary to record data about beverages, food, and therapy. Water and energy content were then reported based on a national nutritional database. Ninety-five patients were included in the analysis. uOsm did not differ between patients with or without dysphagia, with uOsm > 500 mosm/kg in 58.1% at admission and 57.8% at discharge. Inadequate fluid intake was found in 41.2% of the sample with no difference between groups. Insufficient energy intake was found in 95.6% of the sample, with no patients with dysphagia reaching the minimum suggested amount. Our results suggest that a relevant proportion of stroke patients with and without dysphagia may not improve their hydration status during the first days after admission. Diet and therapy were insufficient to achieve recommended fluid intake and energy intake in a large proportion of patients, suggesting a more careful monitoring of hydration and nutrition needs.