Figure and Table | Nutritional Risk Indicators for Predicting a Change in Quadriceps Muscle Thickness in Acute Patients with Stroke

Table 1. Patient Characteristics.

From: Nutritional Risk Indicators for Predicting a Change in Quadriceps Muscle Thickness in Acute Patients with Stroke

Variable	Overall (n = 118)
Age (year)	80.2 (8.8)
Male sex, n (%)	61 (51.7)
Prestroke modified Rankin scale	0 [0, 1]
Charlson Comorbidity Index	1 [0, 1]
Stroke type, n (%)
Cerebral infarction	93 (78.8)
Intracerebral hemorrhage	25 (21.2)
Location of stroke, n (%)
Supratentorial	110 (93.2)
Infratentorial	8 (6.8)
Paralysis, n (%)
Right hemiplegia	59 (50.0)
Left hemiplegia	59 (50.0)
Brunnstrom stage of paralytic side	5 [3, 6]
National Institutes of Health Stroke Scale	5 [3, 10]
C-reactive protein, mg/dL	0.16 [0.06, 0.34]
Serum albumin, g/dL	3.9 [3.7, 4.2]
Total cholesterol, mg/dL	191 (38)
Total lymphocytes, /mm3	1434 [1001, 1868]
BMI, kg/m²	23.1 (3.6)
Energy intake during 2 weeks,
kcal/actual body weight/day	22.4 (7.6)
Oral intake	19.8 (10.0)
Enteral nutrition	1.2 (4.0)
Parenteral nutrition	1.3 (2.4)
Protein intake during 2 weeks,
g/actual body weight/day	0.9 (0.3)
Oral intake	0.8 (0.4)
Enteral nutrition	0.1 (0.2)
Parenteral nutrition	0.1 (0.1)
Days from admission to the initiation of rehabilitation	1 [1, 2]
Estimated time of rehabilitation dose during 2 weeks, minute/day	107 [85, 122]

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Table 2. Patients’ Nutritional Risk as Assessed Using the Three Nutritional Indicators.

From: Nutritional Risk Indicators for Predicting a Change in Quadriceps Muscle Thickness in Acute Patients with Stroke

Limb	Nutritional risk	n (%)	QMT at admission (cm)		QMT after 2 weeks (cm)		Change in QMT (cm)
			Median (IQR)	P value	Median (IQR)	P value	Median (IQR)	P value
Paralytic	GNRI
Paralytic	High risk (<92)	20 (17.0)	1.80 [1.16, 2.33]	<0.001¹	1.44 [1.31, 2.00]	<0.001¹	−0.17 [−0.46, 0.03]	0.561¹
	Low risk (≥92)	98 (83.0)	2.74 [2.27, 3.23]		2.49 [2.04, 2.98]		−0.24 [−0.50, 0.02]
	CONUT
	High risk (5-12)	11 (9.3)	1.85 [1.67, 2.34]	0.017¹	1.88 [1.45, 2.15]	0.004¹	−0.28 [−0.46, 0.08]	0.853¹
	Low risk (0-4)	107 (90.4)	2.71 [2.22, 3.21]		2.42 [1.95, 2.90]		−0.42 [1.95, 2.90]
	MNA-SF
	Malnourished (0-7)	48 (40.7)	2.30 [1.83, 2.86]³,*⁴	<0.001 ²	2.03 [1.46, 2.42]³,⁴	<0.001²	−0.33 [−0.58, 0.04]	0.181²
	At risk of malnutrition (8-11)	60 (50.8)	2.75 [2.29, 3.18]		2.59 [2.00, 3.01]		−0.18 [−0.44, 0.09]
	Normal nutritional status (12-14)	10 (8.5)	3.32 [2.69, 3.72]		3.16 [2.51, 3.48]		−0.16 [2.51, 3.48]
Non-paralytic	GNRI
	High risk	―	1.89 [1.37, 2.52]	<0.001¹	1.77 [1.39, 2.01]	<0.001¹	−0.12 [−0.33, 0.08]	0.624¹
	Low risk	―	2.74 [2.37, 3.27]		2.61 [2.13, 3.14]		−0.17 [−0.39, 0.03]
	CONUT
	High risk	―	2.08 [1.52, 2.80]	0.014¹	1.78 [1.60, 2.01]	0.004¹	−0.04 [−0.56, 0.08]	0.835¹
	Low risk	―	2.65 [2.24, 3.27]		2.52 [2.03, 3.02]		−0.17 [−0.38, 0.03]
	MNA-SF
	Malnourished At risk of malnutrition	―	2.42 [1.79, 3.00]**⁴	0.003 ²	1.97 [1.60, 2.75] ³,⁴	<0.001 ²	−0.25 [−0.45, −0.08]*³	0.007²
	Malnourished At risk of malnutrition	―	2.73 [2.39, 3.22]		2.61 [2.22, 3.22]		−0.08 [−0.36, 0.12]
	Normal nutritional status	―	3.45 [2.64, 3.76]		3.20 [2.52, 3.90]		−0.03 [−0.32, 0.16]

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Table 3. Univariate Analysis of Gait Independence Degree at Discharge.

From: Nutritional Risk Indicators for Predicting a Change in Quadriceps Muscle Thickness in Acute Patients with Stroke

	Gait independence degree
	Independent	Non-independent	P value
	n = 61	n = 46
Age (year)	76 [71, 83]	85 [78, 91]	<0.001¹
Stroke type, n (%)
Cerebral infarction	51 (83.6)	10 (16.4)	0.085²
Intracerebral hemorrhage	32 (69.6)	14 (30.4)
National Institutes of Health Stroke Scale	3 [2, 5]	10 [5, 17]	<0.001¹
Length of rehabilitation, days	41 [19, 66]	91 [49, 127]	<0.001¹
Length of hospitalization	42 [20, 69]	93 [52, 129]	<0.001¹
Gait independence at the initiation of rehabilitation, (%)	12 (19.7)	0 (0)	0.001³
Change in QMT during 2 weeks
Paralytic	−0.18 [−0.45, −0.08]	−0.33 [−0.63, −0.01]	0.105¹
Non-paralytic	−0.04 [−0.30, 0.10]	−0.31 [−0.56, −0.11]	<0.001¹

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Table 4. Multivariate Analysis of QMT Change during the 2-week Follow-up and Nutritional Risk at Admission Using Three Nutritional Indicators.

From: Nutritional Risk Indicators for Predicting a Change in Quadriceps Muscle Thickness in Acute Patients with Stroke

Limb	Nutritional risk	B	P value	95% CI		β
Limb	Nutritional risk	B	P value	Lower	Upper	β
Paralytic	GNRI
	Low risk	Reference
	High risk	−0.106	0.070	−0.221	0.009	−0.187
	CONUT
	Low risk	Reference
	High risk	−0.049	0.464	−0.180	0.082	−0.068
	MNA-SF
	Normal nutritional status	Reference
	At risk of malnutrition	0.047	0.386	−0.060	0.153	0.072
	Malnourished	−0.108	0.109	−0.241	0.024	−0.162
Non-paralytic	GNRI
	Low risk	Reference
	High risk	−0.013	0.803	−0.113	0.088	−0.027
	CONUT
	Low risk	Reference
	High risk	−0.022	0.697	−0.137	0.092	−0.038
	MNA-SF
	Normal nutritional status	Reference
	At risk of malnutrition	0.037	0.416	−0.053	0.128	0.070
	Malnourished	−0.143	0.013*	−0.254	−0.031	−0.258

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Table 5. Multivariate Analysis of Gait Independence Degree at Discharge.

From: Nutritional Risk Indicators for Predicting a Change in Quadriceps Muscle Thickness in Acute Patients with Stroke

	Model 1		Model 2
	OR (95% CI)	P value	OR (95% CI)	P value
Age (year)	0.908 (0.842-0.971)	0.007	0.905 (0.835-0.970)	0.008
Stroke type, cerebral infarction	0.976 (0.218-4.041)	0.973	0.532 (0.144-1.817)	0.982
National Institutes of Health Stroke Scale on admission	0.819 (0.708-0.920)	.003	0.822 (0.713-0.920)	0.002
Length of rehabilitation, days	0.975 (0.957-0.990)	0.003	0.978 (0.959-0.993)	0.016
Change in QMT during 2 weeks (paralytic limb)	0.98 (0.212-4.611)	0.981
Change in QMT during 2 weeks (non-paralytic limb)		12.710 (1.722-120.520)	0.017

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