Prevalence of malnutrition in convalescent rehabilitation wards in Japan and correlation of malnutrition with ADL and discharge outcome in elderly stroke patients

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  • 本邦回復期リハビリテーション病棟入棟患者における栄養障害の実態と高齢脳卒中患者における転帰、ADL帰結との関連
  • ホンポウ カイフクキ リハビリテーション ビョウトウニュウトウ カンジャ ニ オケル エイヨウ ショウガイ ノ ジッタイ ト コウレイ ノウソッチュウ カンジャ ニ オケル テンキ 、 ADL キケツ ト ノ カンレン

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Objective: The objectives of this study were to investigate the prevalence of malnutrition in convalescent rehabilitation wards in Japan and to investigate whether malnutrition affects activities of daily living (ADLs) and the discharge outcome.<br>Method: This study included 230 elderly patients (111 males and 119 females). Their average age was 78.7 ± 7.5 years. Of the 230 patients, 134 suffered from stroke, 47 from musculoskeletal disorders, 14 from disuse syndrome, and 35 from other ailments or diseases. These patients were discharged from 9 rehabilitation hospitals in February 2012. Age, sex, primary disease, type of nutritional support, nutritional status, anthropometric data, laboratory data, discharge outcome, Functional Independence Measure (FIM) on admission, and FIM at discharge were analyzed.<br>Results: A total of 43.5% of subjects were defined as malnourished according to the Geriatric Nutritional Risk Index (GNRI). The FIM of malnourished stroke patients was lower than that of well-nourished patients (p < 0.01). Multiple regression analysis revealed that the degree of malnutrition and FIM on admission were significantly correlated with FIM at discharge (R2 = 0.734). The degree of malnutrition was also negatively correlated with rate of home discharge (odds ratio = 0.580).<br>Conclusion: This study suggests a high prevalence of malnutrition in convalescent rehabilitation wards and a negative correlation of malnutrition with improvement of ADLs and rate of home discharge. These findings indicate that it is important that nutritional assessment must be undertaken early in convalescent rehabilitation wards in Japan.

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