| Summary: | Aims: The aims of this work were to describe the nutritional status of acute stroke patients after admission and during the hospital stay, to measure the impact of nutritional status on clinical outcomes and to examine the effect of nutritional intervention on nutritional status and outcome. Methods: The nutritional status was evaluated using a semi-quantitative food frequency questionnaire and anthropometric, haematological and biochemical data. Clinical outcome measures were recorded during the hospital stay, at death or discharge and at three months. The influence of nutritional status on clinical outcome was measured after adjusting for non-nutritional clinical variables. A randomised controlled trial of oral nutritional supplements was performed. Results: Plasma concentrations of vitamin C were significantly lower in the stroke group compared with the non-stroke group. Pre-stroke residence and sex predicted nutritional status. Most patients studied were in negative energy balance during the hospital stay. Nutritional status deteriorated significantly during the study period, but only serum albumin showed a statistically significant association with various outcome measures. Hypoalbuminaemia was associated with a significantly higher level of morbidity and mortality during the hospital stay and at three months. Oral supplementation significantly improved nutritional intake, prevented or reduced the decline in nutritional status and had a favourable but non-significant effect on outcome. Discussion: A significant number of acute stroke patients were undernourished at admission, and this worsened during their hospital stay. Undernutrition was associated with increasing morbidity and mortality. Nutritional supplementation significantly improved nutritional intakes and prevented the decline in nutritional status, but whether that removed or mitigated the hazard of stroke death associated with poor nutritional status is at present unknown.
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