Changes in nutritional state and dysphagia in stroke patients monitored during a 14-d period in a Burkina Faso hospital setting

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2018-04, Vol.48, p.55-60
• Main Authors: Diendéré, Jeoffray, Millogo, Athanase, Preux, Pierre-Marie, Jésus, Pierre, Desport, Jean-Claude
• Format: Article
• Language: English
• Subjects: Arm circumference; Body mass index; Body size; Burkina faso; Caregivers; Cerebrovascular accident; Cerebrovascular system; Confidence intervals; Consent; Developed countries; Dietary transition; Dysphagia; Food; Hospitals; Hyperglycemia; Multivariate analysis; Nutrition; Parenteral nutrition; Patients; Siblings; Skinfold thickness; Stroke; Undernourishment
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2017.10.022

•Undernourishment prevalence was high at inclusion and worsened until the 14th day.•Nutritional status should be assessed on admission using triceps skinfold and BMI.•Women were particularly at risk of undernourishment after stroke.•Poststroke dysphagia prevalence was low and may be underestimated.•Multidisciplinary caring with formal guidelines of dysphagia was needed. Dysphagia and undernourishment are common in cerebrovascular accident (stroke) patients in developed countries. Despite the dietary transition, there is little information available in Africa on this topic. This study aims to assess the prevalence of undernourishment and dysphagia in stroke patients in two Burkina Faso teaching hospitals at a starting point (D0), on the eighth day, and on the 14th (D14) and to specify factors related to undernourishment at day 14. The nutritional state of the patients was assessed using body mass index, triceps skinfold thickness, and mid-upper arm circumference. Dysphagia was identified using the Practical Aspiration Screening Schema. A total of 222 patients were included in the study. From D0 to D14, the prevalence of undernourishment increased from 25.2% to 31.0% and the prevalence of dysphagia decreased from 37.4% to 15.8%. All nutritional criteria worsened. In a multivariate analysis, undernourishment was more present at D14 for women (odds ratio [OR] = 7.01; 95% confidence interval [CI]: 1.51–32.56, P = 0.01) and was less present if weight (OR = 0.69; 95% CI: 0.60–0.79, P = 0.0001) or triceps skinfold thickness (OR = 0.85; 95% CI: 0.74–0.99, P = 0.03) were high at D0. The prevalence of undernourishment was high at D0 and increased during the monitoring period. It would be advisable to monitor patients' weight and triceps skinfold thickness, to optimize care for women and patients with low weight or triceps skinfold thickness at D0, to monitor dysphagia, and to inform patients, families, and relevant staff of nutritional concerns after a cerebrovascular accident.