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allied
academies
March 14-16, 2019 | London, UK
12
th
International Conference on
8
th
International Conference on
Vascular Dementia and Dementia
Neurological Disorders and Stroke
Joint Event
&
Journal of Brain and Neurology | Volume 3
Analysis of medical enteral nutrition of Acute Stroke patients in a Hungarian Stroke Center
Béres-Molnár KA
1
, Jarecsny T
1
, Al-Muhanna N
1
, Jánoska D
1
, Dudás E
1
, Köles B
1
, Folyovich A
1
, Kovács A
2
and
Molnár A
3
,
1
Szent János Hospital, Hungary
2
Hungarian Dietetic Association, Hungary
3
Semmelweis University, Hungary
Introduction:
30-50% of acute stroke patients (ASPs) suffer
from dysphagia. These patients have a higher risk for
dehydration, malnutrition, aspiration pneumonia, pressure
ulcer. Their prognosis is worse, mortality is higher. However,
the medical enteral nutrition (MET) is not sufficiently known at
neurological departments. To change it, it is necessary to know
the number and characteristics of patients with dysphagia.
Early malnutrition, sarcopenia, dysphagia screening and
management are recommended.
Patients and method:
malnutrition universal screening tool
(MUST) and clinical bedside dysphagia assessment (CBA) by
trained speech therapist were the screening methods. Latter
contained Water-Swallowing-Test (WST), Multiple-Consistency-
Test, Gugging Swallowing Screen (GUSS), Swallowing-
Provocation-Test (SPT) were carried out in all ASPs after hospital
admission. Our prospective study contains the data of ASPs
admitted to our department. Their routine therapeutic protocol
was supplemented by MET. We analyzed the history of the first
31 (23 women, 8 men) ASPs.
Results:
The average age of the patients was 79.66 years,
neurological state (modified Rankin Scale - mRS – average value:
4.84)wasserious,nutritionalriskwashigh(MUST-score-average:
2.90). The most common co-morbidities were hypertension,
diabetes, atrial fibrillation. 4 patients had Clostridium difficile
infection. 10 patients had remarkable dysphagia. At the time of
admission 9 patients were malnourished, 3 overweight. During
the hospitalisation 5 patients were fed orally, 25 by nasogastric
tube, 1 via PEG. 18 patients died, 10 patients were transmitted
to chronic or rehabilitation ward, 3 were discharged home. The
mRS value of the survivals fell down from 4.58 to 4.08.
Conclusion:
MET is administrated usually for ASPs with
serious general and neurological condition independently
from dysphagia. Improvement can be achieved in survivors of
this group as well and the role of MET is presumable. MET for
patients with less severe condition is certainly useful, for this
purpose further cost-effectiveness studies are needed.
Speaker Biography
Béres-Molnár KA was graduated at the Medical Faculty of Semmelweis University, and
trained at the Department of Neurology and Stroke of Szent János University Hospital,
Budapest. She obtained Board Certification in Neurology in 2017. Her main areas of
scientific interest are immunological changes during acute stroke, stroke epidemiology
and medical enteral nutrition of stroke patients. She is the Secretary of Horányi Béla
Clinical Neuroscience Society and of Board of Trustees of Csanda Endre Neurological
Foundation.
e:
beres.molnar@gmail.com