Naofumi Isono1, Yuki Imamura2, Keiko Ohmura2, Norihide Ueda3, Shinji Kawabata4, Motomasa Furuse4, Toshihiko Kuroiwa4. 1. Department of Neurosurgery, Higashi-Sumiyoshi Morimoto Hospital, Osaka, Japan. Electronic address: neuisono@tachibana-med.or.jp. 2. Clinical Nutrition and Food Service, Higashi-Sumiyoshi Morimoto Hospital, Osaka, Japan. 3. Clinical Nutrition and Food Service, Higashi-Sumiyoshi Morimoto Hospital, Osaka, Japan; Clinical Nutrition and Food Service, Kokuho Central Hospital, Shiki, Japan. 4. Department of Neurosurgery, Osaka Medical College, Takatsuki, Japan.
Abstract
OBJECTIVE: For stroke patients, intensive nutritional management is an important and effective component of inpatient rehabilitation. Accordingly, acute care hospitals must detect and prevent malnutrition at an early stage. Blood transthyretin levels are widely used as a nutritional monitoring index in critically ill patients. Here, we had analyzed the relationship between the transthyretin levels during the acute phase and Functional Independence Measure in stroke patients undergoing convalescent rehabilitation. METHODS: We investigated 117 patients who were admitted to our hospital with acute ischemic or hemorrhagic stroke from February 2013 to October 2015 and subsequently transferred to convalescent hospitals after receiving acute treatment. Transthyretin concentrations were evaluated at 3 time points as follows: at admission, and 5 and 10 days after admission. After categorizing patients into 3 groups according to the minimum transthyretin level, we analyzed the association between transthyretin and Functional Independence Measure. RESULTS: In our patients, transthyretin levels decreased during the first 5 days after admission and recovered slightly during the subsequent 5 days. Notably, Functional Independence Measure efficiency was significantly associated with the decrease in transthyretin levels during the 5 days after admission. Patients with lower transthyretin levels had poorer Functional Independence Measure outcomes and tended not to be discharged to their own homes. DISCUSSION: A minimal transthyretin concentration (<10 mg/dL) is predictive of a poor outcome in stroke patients undergoing convalescent rehabilitation. In particular, an early decrease in transthyretin levels suggests restricted rehabilitation efficiency. Accordingly, transthyretin levels should be monitored in acute stroke patients to indicate mid-term rehabilitation prospects.
OBJECTIVE: For strokepatients, intensive nutritional management is an important and effective component of inpatient rehabilitation. Accordingly, acute care hospitals must detect and prevent malnutrition at an early stage. Blood transthyretin levels are widely used as a nutritional monitoring index in critically illpatients. Here, we had analyzed the relationship between the transthyretin levels during the acute phase and Functional Independence Measure in strokepatients undergoing convalescent rehabilitation. METHODS: We investigated 117 patients who were admitted to our hospital with acute ischemic or hemorrhagic stroke from February 2013 to October 2015 and subsequently transferred to convalescent hospitals after receiving acute treatment. Transthyretin concentrations were evaluated at 3 time points as follows: at admission, and 5 and 10 days after admission. After categorizing patients into 3 groups according to the minimum transthyretin level, we analyzed the association between transthyretin and Functional Independence Measure. RESULTS: In our patients, transthyretin levels decreased during the first 5 days after admission and recovered slightly during the subsequent 5 days. Notably, Functional Independence Measure efficiency was significantly associated with the decrease in transthyretin levels during the 5 days after admission. Patients with lower transthyretin levels had poorer Functional Independence Measure outcomes and tended not to be discharged to their own homes. DISCUSSION: A minimal transthyretin concentration (<10 mg/dL) is predictive of a poor outcome in strokepatients undergoing convalescent rehabilitation. In particular, an early decrease in transthyretin levels suggests restricted rehabilitation efficiency. Accordingly, transthyretin levels should be monitored in acute strokepatients to indicate mid-term rehabilitation prospects.
Authors: Henning J Drews; Konstantin Yenkoyan; Ali Lourhmati; Marine Buadze; Daniela Kabisch; Stephan Verleysdonk; Stefan Petschak; Sandra Beer-Hammer; Tigran Davtyan; William H Frey; Christoph H Gleiter; Matthias Schwab; Lusine Danielyan Journal: Neurotherapeutics Date: 2019-07 Impact factor: 7.620
Authors: Viviënne Huppertz; Sonia Guida; Anne Holdoway; Stefan Strilciuc; Laura Baijens; Jos M G A Schols; Ardy van Helvoort; Mirian Lansink; Dafin F Muresanu Journal: Front Neurol Date: 2022-02-01 Impact factor: 4.003