Sains Malaysiana 48(1)(2019): 129–135

http://dx.doi.org/10.17576/jsm-2019-4801-15

Nutritional Status of Post-Acute Stroke Patients during Rehabilitation Phase in Hospital

(Status Pemakanan Pesakit Selepas Strok semasa Fasa Pemulihan di Hospital)

CHONG CHIN WEUN¹, NAZIRAH HASNAN², LYDIA ABDUL LATIF² & HAZREEN ABDUL MAJID^1*

¹Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

²Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

Diserahkan: 2 Mei 2018/Diterima: 30 Ogos 2018

ABSTRACT

Malnutrition is highly prevalent among stroke patients during post-acute rehabilitation phase and may give a negative effect on rehabilitation and impair recovery. However, to date, there is no reported study in Malaysia investigating the nutritional status of stroke patients during rehabilitation phase. Thus, this paper aims to report the preliminary results of nutritional assessment for a randomized controlled trial at baseline. All participating patients were assessed for anthropometric measurements, nutritional status using validated Mini Nutrition Assessment (MNA), 24 h diet recall, and handgrip strength. Demographic data, biochemical profiles and functional outcomes (Modified Barthel Index Score, Motor Assessment Scale) were obtained from patients’ medical record. From a total of 45 post-acute stroke patients at baseline, 24.4% of them were malnourished during admission to rehabilitation ward and 66.7% of the patients were at risk of malnutrition. Mean dietary intake and protein intake of the patients were 1489 ± 297 kcal/day and 66.1 ± 17.2 g/day, respectively. Mean handgrip strength for the patients was 17.9 ± 8.1 kg. Weight, body mass index, serum albumin, handgrip strength, Modified Barthel Index and Motor Assessment Scale score were positively correlated with MNA score (p<0.05), but no correlation was found for the dietary intake (r=0.163, p=0.285) and protein intake (r=0.288, p=0.055). This preliminary result showed that stroke patients are particularly at risk of malnutrition or malnourished during the rehabilitation period. Therefore, early identification of malnutrition for stroke patients is important for a successful rehabilitation program.

Keywords: Dietary intake; malnutrition; nutritional assessment

ABSTRAK

Malnutrisi adalah umum dalam kalangan pesakit strok semasa fasa pemulihan dan ini mungkin akan memberikan kesan negatif kepada proses pemulihan dan melambatkan proses penyembuhan. Walau bagaimanapun, tiada kajian di Malaysia yang menilai status pemakanan pesakit strok semasa fasa pemulihan. Kertas ini bertujuan untuk melaporkan keputusan penilaian pemakanan asas bagi satu kajian percubaan terkawal rawak (RCT). Semua pesakit yang terlibat dalam kajian tersebut telah dinilai dengan pengukuran antropometri, status pemakanan menggunakan Penilaian Pemakanan Mini (MNA), ingatan diet 24 jam dan kekuatan genggaman tangan. Data demografi, profil biokimia dan hasil ukuran kefungsian (Modified Barthel Index Score/MBI, Motor Assessment Scale/MAS) telah diperoleh daripada rekod perubatan pesakit. Daripada 45 orang pesakit selepas strok yang telah dinilai, 24.4% pesakit adalah malnutrisi manakala 66.7% pesakit adalah berisiko untuk mendapat malnutrisi. Purata pengambilan pemakanan dan pengambilan protein masing-masing adalah 1489 ± 297 kkal/hari dan 66.1 ± 17.2 g/hari. Purata kekuatan genggaman tangan adalah 17.9 ± 8.1 kg. Berat badan, indeks jisim tubuh, albumin darah, kekuatan tangan, MBI dan MAS menunjukkan hubungan kolerasi positf dengan skor MNA (p<0.05) manakala tiada kolerasi antara skor MNA dengan pengambilan pemakanan (r=0.163, p=0.285) dan pengambilan protein (r=0.288, p=0.055). Keputusan asas kajian ini menunjukkan pesakit strok adalah berisiko tinggi untuk mendapat malnutrisi semasa fasa pemulihan. Dengan sedemikian, pengesanan awal risiko malnutrisi adalah sangat penting dalam kalangan pesakit strok untuk proses pemulihan yang berkesan.

Kata kunci: Malnutrisi; penilaian pemakanan; pengambilan pemakanan

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*Pengarang untuk surat-menyurat; email: hazreen@ummc.edu.my