Effects of early enteral nutrition support on the nutritional status and outcomes of patients with post-stroke dysphagia

Objective To evaluate the effect of enteral nutrition support on the nutritional status and clinical outcomes of patiems with dysphagia after stroke.Methods 148 patients with acute stroke and associated dysphagia were enrolled from August 2013 to July 2014 in the Fifth Affiliated Hospital of Zhengzhou University,and randomly divided into 2 groups by drawing lots within 48 hours after admission:enteral nutrition group (n =75,early enteral nutrition support) and control group (n =73,routine diet).The nutritional status (triceps skinfold thickness,levels of serum total protein,albumin and hemoglobin),incidence of lung infection,mortality,and neurological function were compared between the two groups on day 1 and day 21 after admission.Results On day 1 after admission,the triceps skinfold thickness,levels of serum total protein,albumin,and hemoglobin in the enteral nutrition group were not significantly different from those in the control group [(15.4 ±4.1) mm vs.(15.1 ± 3.7) mm,t=1.36,P=0.392; (75.7±2.6) g/Lvs.(76.6±3.1) g/L,t=1.12,P=0.254; (39.2± 1.8) g/Lvs.(38.7±2.1) g/L,t=1.24,P=0.200; (137.4±14.5) g/Lvs.(135.1±15.3) g/L,t=1.01,P =0.461].On day 21 after admission,all the 4 nutrition indicators were significantly higher in the enteral nutrition group than in the control group [(13.5 ±3.9) mmvs.(11.2±4.6) mm,t=2.08,P=0.019; (63.3±4.1) g/Lvs.(57.1±4.7) g/L,t=4.01,P=0.001; (35.7±1.6) g/Lvs.(34.1± 2.0) g/L,t=2.31,P=0.022; (125.7 ±17.9) g/Lvs.(120.3 ±16.7) g/L,t=2.39,P=0.027].The enteral nutrition group showed lower incidence of lung infection,mortality,and reduced scores of American National Institutes of Health Stroke Scale compared with the control group (41.3％ vs.63.2％,x2 =9.69,P =0.002; 15.3％ vs.21.2％,x2=3.27,P=0.014; 11.1 ±4.1 vs.14.7 ±3.9,t=2.98,P=0.007).Conclusions Early enteral nutrition support can improve the nutritional status and outcomes of stroke patients with dysphagia.In addition,early enteral nutrition support may also be helpful for the improvement of the neurological function. Key words: Stroke ;  Dysphagia;  Nutritional status ;  Pulmonary infection ;  Clinical outcome