To investigate the prevalence of nutritional risk and undernutrition, and the application of nutrition support among inpatients with cerebral infarction or cerebral hemorrhage in Department of Neurology in a tertiary hospital in Shenzhen, Guangdong Province, to estimate the situation of the whole hospital, so as to provide guidance for standardizing nutrition support.

A total of 2 261 inpatients who were treated in Department of Neurology in Peking University Shenzhen Hospital were initially selected from September 2014 to March 2016 using consecutive sampling. After 164 patients were excluded for short hospital stay (<24 hours), age < 18 years or > 90 years, obnubilation, and/or refusal to participate, 2 097 patients were sampled. After patients who did not meet the scheduled diagnosis were excluded, 605 patients with cerebral infarction or cerebral hemorrhage were enrolled. Nutritional Risk Screening 2002 (NRS 2002) was applied within the first 24-48 hours after admission to estimate the prevalence of nutritional risk and undernutrition. Nutrition support within 14 days (or until discharge) was evaluated.

Among the 605 patients (561 cases of cerebral infarction, 44 cases of cerebral hemorrhage), 272 had nutritional risk (44.96%), the prevalence of nutritional risk in inpatients with cerebral infarction or cerebral hemorrhage was 45.63%(256/605) and 36.36%(16/44), respectively. The total prevalence of undernutrition was 1.82%(11/605). The prevalence of undernutrition in patients with cerebral infarction or cerebral hemorrhage was 1.07% (6/561) and 0, respectively, if based on a score of 3 in impaired nutritional status of NRS 2002; 0.71%(4/561) and 2.27%(1/44)if based on body mass index≤18.5 kg/m². Only 29(10.7%) of the 272 patients with nutritional risk received nutrition support, with the energy and nitrogen intake being (15.6±2.0)kcal/(kg·d)(1 kcal=4.184 kJ) and (0.10±0.02)g/(kg·d), respectively. In the 333 patients without nutritional risk, 27 (8.1%) received nutrition support.

The prevalence of nutritional risk is very high in the patients with cerebral infarction or cerebral hemorrhage in this hospital, while the prevalence of undernutrition is very low. The application of nutrition support in the patients with nutritional risk is very low, mainly in the form of enteral nutrition, but with insufficient energy and nitrogen intake. At the same time, overuse of nutrition support is also observed. Using undernutrition as the indication of nutrition support, only 1.82% patients need nutrition support; but if nutritional risk is considered the indication of nutrition support, 44.96% patients need nutrition support. Whether nutrition support in patients with nutritional risk could improve patient outcome is the topic in our future research.

Nutritional Risk Screening 2002; Cerebral infarction; Cerebral hemorrhage; Nutritional risk; Undernutrition; Nutrition support