Influencing factors of nutritional risks and rehabilitation nursing countermeasures in stroke patients

Objective To explore the nutritional risk influencing factors in stroke patients， and to discuss the formulation of rehabilitation nursing countermeasures.

Methods We randomly selected 152 patients with acute hemorrhagic stroke admitted to our hospital from July 2018 to July 2020. Based on the results of the mini nutritional assessment （MNA） score， the patients were divided into normal group （49 cases）， risk group （53 cases）， and bad group （50 cases）. Single factor analysis and correlation analysis were used to analyze the nutritional risk factors， and the countermeasures for the influencing factors were discussed.

Results Univariate analysis showed that stroke time， mechanical ventilation， swallowing dysfunction， ADL score， upper arm muscle circumference， serum albumin， and total lymphocyte count in risk and bad groups were different from the normal group. In comparison， the proportion of patients with mechanical ventilation and swallowing dysfunction was higher， and ADL score， upper arm muscle circumference， serum albumin level and total lymphocyte count were lower （P<0.05）. The Spearman rank correlation analysis showed that the factors with differences in the univariate analysis also showed correlation （P<0.05）. Among them， the positive correlation factors included the duration of stroke， receiving mechanical ventilation， swallowing dysfunction， NIHSS score， negatively related factors included ADL score， serum levels of albumin， transferrin， and hemoglobin. Multivariate Logistic regression analysis showed that stroke time （OR=1.739， P<0.001） and swallowing dysfunction （OR=3.966， P=0.008） were independent risk factors for malnutrition. ADL score （OR=0.687， P<0.001）， upper arm muscle circumference （OR=0.770， P=0.012）， serum albumin level （OR=0.870， P=0.003） were independent protective factors for malnutrition.

Conclusion The nutritional status in stroke patients is not optimistic. Most patients have swallowing disorders， motor dysfunction， and poor self-care ability. At the same time， the body protein content in patients has decreased significantly. The clinical work is needed to deal with the patients' swallowing function recovery together with the treatment of nerve damage.