Highlights
- •Risk of dehydration and malnutrition is common during hospitalization.
- •Despite fluid therapy, hydration status may not improve during acute hospitalization.
- •Fluid volume coming from oral sources predicts hydration status at discharge.
- •Including enteral and parenteral fluids may not predict hydration status at discharge.
Abstract
Proper hydration and nutrition have been found to be contributing factors to a better
recovery in patients after stroke. A better knowledge of factors influencing fluid
and energy intake may contribute to a better care of the acute stroke patient. Aim
of this study was to describe hydration status, fluid intake, and energy intake of
stroke patients during acute hospitalization in a stroke unit. A retrospective descriptive
study was conducted in stroke patients admitted to a stroke unit. All patients received
neurological evaluation and urinary osmolality (uOsm) measure at admission and discharge.
During stroke unit stay patients received a day-by-day diary to record data about
beverages, food, and therapy. Water and energy content were then reported based on
a national nutritional database. Ninety-five patients were included in the analysis.
uOsm did not differ between patients with or without dysphagia, with uOsm > 500 mosm/kg
in 58.1% at admission and 57.8% at discharge. Inadequate fluid intake was found in
41.2% of the sample with no difference between groups. Insufficient energy intake
was found in 95.6% of the sample, with no patients with dysphagia reaching the minimum
suggested amount. Our results suggest that a relevant proportion of stroke patients
with and without dysphagia may not improve their hydration status during the first
days after admission. Diet and therapy were insufficient to achieve recommended fluid
intake and energy intake in a large proportion of patients, suggesting a more careful
monitoring of hydration and nutrition needs.
Keywords
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Article info
Publication history
Published online: January 14, 2019
Accepted:
January 4,
2019
Received:
December 3,
2018
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
