30.8% of patients were at moderate to severe risk of malnutrition.
The overall incidence of was 33.2%.
A negative dose-response relationship was found between the (GNRI) score and post-stroke myocardial injury.
Moderate to severe malnutrition risk, as evaluated by the GNRI score, was associated with an increased risk of post-stroke myocardial injury (OR: 3.25).
After adjusting for confounders, the association remained robust, with an odds ratio of 4.28 following propensity score matching.
Simplified
BACKGROUND: is a potentially preventable complication after acute ischemic stroke. Therefore, identifying modifiable variables, such as nutritional status, is crucial for reducing the risk of post-stroke myocardial injury. This study aimed to investigate the association between malnutrition risk on admission, as evaluated by the (GNRI), and post-stroke myocardial injury in elderly patients with first‑ever ischemic stroke.
METHODS: We conducted this study using the GNRI score to evaluate the nutritional status of older patients with first‑ever ischemic stroke. The primary outcome of interest was post-stroke myocardial injury. Restricted cubic spline (RCS) was executed to assess the dose-effect relationship between the GNRI score and post-stroke myocardial injury. The correlation of malnutrition risk identified by GNRI score for post-stroke myocardial injury was examined using multivariate logistic regression analysis. To balance the potential confounders and verify the robustness of the results, propensity score matching (PSM) was further conducted.
RESULTS: Based on the GNRI score, 30.8% of patients were at moderate to severe risk of malnutrition. The overall incidence of post-stroke myocardial injury was 33.2%. The adjusted RCS analysis revealed a negative dose-response relationship between the GNRI score and post-stroke myocardial injury (P for non-linearity = 0.536). After adjusting for confounders, moderate to severe malnutrition risk, as evaluated by the GNRI score, was substantially associated with an increased risk of post-stroke myocardial injury (OR: 3.25; 95% CI: 1.93-5.48; P < 0.001). Following PSM adjustment, the association between the GNRI score and post-stroke myocardial injury remained significantly robust (OR: 4.28; 95% CI: 2.34-7.83; P < 0.001).
CONCLUSION: Malnutrition risk on admission is associated with higher risk of post-stroke myocardial injury among elderly patients with first‑ever ischemic stroke. Early screening for malnutrition risk is crucial in the management of patients with first‑ever ischemic stroke.
Key numbers
30.8%
Malnutrition Risk Prevalence
Percentage of patients at moderate to severe malnutrition risk based on score.
33.2%
Incidence
Overall incidence of myocardial injury among stroke patients.
3.25
Increased Risk of Myocardial Injury
for associated with malnutrition risk.
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Declarations. Ethics approval and consent to participate: Study procedures were performed in accordance with the Declaration of Helsinki ethical principles for medical research involving human subjects. The study was approved by the Medical Ethics Committee of The Affiliated Hospital of Xuzhou Medical University (reference No. XYFY2022-YL117-01), and the informed consent was waived due to the retrospective nature of the cohort study. Competing interests: The authors declare no competing interests.
