Association Between Nutritional Status and Mortality/Neurological Outcomes in Stroke Patients: A Systematic Review and Meta-Analysis.

 

Where the hell is the diet protocol that prevents this problem? You didn't think actually solving the problem was necessary? Prognostication was all you were planning on doing? Remind me to never hire you for any job.  An incompetent? doctor will have done nothing for 6 years, like yours! NO protocol; NOTHING!

49% malnutrition post-stroke (1 post to April 2025)

malnutrition (3 posts to August 2019)

muscle wasting (4 posts to September 2012)

Association Between Nutritional Status and Mortality/Neurological Outcomes in Stroke Patients: A Systematic Review and Meta-Analysis.

Jihui Hu, Yang Liu, Yi Zhang, Meng Zhang

J Stroke Cerebrovasc Dis. 2025 Jul 15 108398 [Epub ahead of print]

OBJECTIVE

To systematically evaluate the association between Nutritional Risk Screening 2002 (NRS-2002), Controlling Nutritional Status (CONUT) score, Geriatric Nutritional Risk Index (GNRI), and 3-month mortality and poor neurological outcomes (modified Rankin Scale [mRS] ≥3) in stroke patients.

METHODS

A systematic search of PubMed, Embase, and other databases up to April 2025 identified 11 observational studies (6 prospective cohorts; n=7,696). Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity, sensitivity, and publication bias were assessed. Meta-regression explored sources of heterogeneity. A gradient boosting classifier and Bayesian MCMC simulations were used for supplementary modeling.

RESULTS

NRS-2002 ≥3 (OR=3.42, 95% CI: 2.59-4.51), CONUT ≥5 (OR=3.66, 95% CI: 2.47-5.43), and GNRI <98 (OR=2.68, 95% CI: 1.86-3.84) were significantly associated with poor functional outcomes. These indices also predicted higher 3-month mortality: NRS-2002 ≥3 (OR=4.13), CONUT ≥5 (OR=3.57), GNRI <98 (OR=2.93). Heterogeneity ranged from moderate to high (I²=42.1%-68.9%). Meta-regression implicated regional and clinical factors as sources of variability. Predictive modeling (AUROC = 0.81) identified GNRI <92, age ≥75, and NIHSS as key mortality predictors, consistent with SHAP and Bayesian analyses.

CONCLUSION

Malnutrition-particularly as defined by NRS-2002 ≥3, CONUT ≥5, and GNRI <98-is strongly linked to early mortality and poor recovery after stroke. GNRI showed high predictive value in older patients. Integrating nutritional screening into acute stroke care may enable early, cost-effective interventions to improve outcomes.

Source: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association