Association between nutrition factors, inflammatory and humoral with morbimortality 90 days after stroke

Abstract

The Stroke is defined as an acute neurological dysfunction of vascular origin, with sudden development of clinical signs of brain function disorders lasting more than 24 hours. The diagnosis of stroke must occur concurrently with the application of predictor scales of prognosis and disease severity as the "National Institute of Health Stroke Scale" (NIHSS). Stroke is the leading cause of disability in adulthood and causes a great impact on the lives of victims, families, health systems and economies. Even with an ideal acute therapy, about two thirds of patients does not have a full recovery after stroke. A condition that deserves special attention is the nutritional status of such patients who become more susceptible to involuntary weight loss, as may occur reduced appetite, chewing and swallowing problems (dysphagia), depression and changes in mobility, with consequent functional dependence. Additionally, there is the possibility of development of sarcopenia, defined by loss of muscle mass and function. The sarcopenia is a powerful risk factor for fragility, loss of independence and physical disability in the elderly. On the stroke context, it is common to see physical inactivity, inflammatory and neurohormonal changes, nutritional deficiency of macro and micronutrients. These factors participate in the pathophysiology of sarcopenia. However, little is known if patients develop sarcopenia after stroke, which inflammatory and humoral factors are related to sarcopenia after stroke. In addition, little is known if sarcopenia has clinical implications as reduced functional capacity, rehospitalization and mortality 90 days after stroke. Furthermore, there are no specific recommendations for nutritional therapy after stroke. Therefore, we will study 120 patients with stroke, during their stay in the stroke unit. At this time we will conduct clinical, nutritional and body composition assessment and collection of blood for inflammatory and humoral mediators. After 30 days we will conduct further evaluation of body composition to assess the development of sarcopenia. Finally, after 90 days will be assessed clinical outcomes of functional capacity, mortality and rehospitalization. To determine the associations will be conducted analysis multiple linear and logistic regression, considering a significance level of 5%. (AU)