The Long-term Nutritional Status in Stroke Patients and its Predictive Factors Julie Paquereau, MD,* Etienne Allart, MD,* Monique Romon, MD, PhD,† and Marc Rousseaux, MD, PhD* Background: Malnutrition is common in the first few months after stroke and con- tributes to a poor overall outcome. We analyzed long-term weight changes and their predictive factors. Methods: A total of 71 first-ever stroke patients were included in the study and examined (1) their weight on admission to the acute stroke unit (usual weight [UW]), on admission to the rehabilitation unit, on discharge from the rehabilitation unit, and then 1 year or more after the stroke (median time: 2.5 years), (2) the presence of malnutrition after stroke, and (3) possible predictive factors, namely, sociodemographic factors, clinical characteristics (concerning the stroke, the patient’s current neurologic status and the presence of diabetes mellitus and depression), and the present nutritional state (including eating difficulties, anorexia, and changes in food intake and food preferences). Results: Body weight fell (4.0 kg) during the patients’ stay in the stroke unit, increased moderately in the rehabilitation unit (2.0 kg), and returned to the UW by the long-term measure- ment. However, at the last observation, 40.1% of the patients weighed markedly less than their UW, 38.0% weighed markedly more, and 21.1% were relatively stable. Predictors of weight change were a change in preferences for sweet food products and a change in food intake. Malnutrition was frequent (47.9%) and associated with reduced food intake, residence in an institution, and diabetes mellitus. Conclusions: Malnutrition was highly prevalent, with an important role of change in food intake and food preferences, which could result from brain lesions and specific regimens. Living in an institution needs consideration, as its negative effects can be prevented. Key Words: Stroke prognosis—weight change—malnutrition— predictive factors. Ó 2014 by National Stroke Association Introduction On admission to the acute stroke unit, between 8% and 20% of stroke patients are found to be already suffering from malnutrition. 1-7 The prevalence of malnutrition rises during the first weeks of hospitalization and affects up to 35%-50% of patients. 8-12 Malnutrition is an indicator of a poor outcome at 3-6 months after stroke, 3,9,13-18 and low albumin levels at admission have been identified as an independent predictor of poor outcome and higher mortality in the long term. 19 A few studies have focused on weight changes more than 6 months after a stroke. Continuous weight loss has been reported in 2 studies, 20,21 whereas a third study reported on a gradual reduction in the initial malnutrition after admitting to a rehabilitation unit. 22 In one study, 21 eating disablement was an indicator of poor quality of life. In another study, 20 weight loss greater than 3 kg (rela- tive to the usual weight [UW]) was observed in 66% of patients at 16 months after stroke; haemorrhagic stroke, depression, and persistent eating difficulties were found to be predictive/explanatory factors. Furthermore, this From the *Department of Neurological Rehabilitation, University Medical Center and University of Lille, Lille; and †Department of Nutrition, University Medical Center and University of Lille, Lille, France. Received October 23, 2013; revision received January 7, 2014; accepted January 8, 2014. Address correspondence to Marc Rousseaux, MD, PhD, Depart- ment of Neurological Rehabilitation, H^ opital Swynghedauw, CHRU, F-59037 Lille Cedex, France. E-mail: marc.rousseaux@ chru-lille.fr . 1052-3057/$ - see front matter Ó 2014 by National Stroke Association http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.01.007 Journal of Stroke and Cerebrovascular Diseases, Vol. -, No. - (---), 2014: pp 1-6 1