Page 146 - HA Convention 2016 [Full Version]

HOSPITAL AUTHORITY CONVENTION 2016 Service Enhancement Presentations

F4.6 Clinical Safety and Quality Service II 16:15 Room 421

Predictors of Unintended Weight Loss in Stroke Patients on Rehabilitation
LO WK, KAM WC
Dietetics Department, Alice Ho Mui Ling Nethersole Hospital and Tai Po Hospital, Hong Kong

Introduction

Unintended weight loss (UWL) indicates body mass loss which adversely affects a patient’s functional outcomes. UWL is
common among stroke patients on rehabilitation. Currently in Tai Po Hospital (TPH), Malnutrition Screening Tool (MST) is
used to screen for malnutrition risk based on patient’s appetite and past weight loss, which may be useful to predict UWL.
Studies have suggested other predictors for UWL, such as body mass index (BMI), dysphagia, tube feeding and patient
length of stay (LOS).

Objectives
To identify the predictors of UWL in stroke patients on rehabilitation in TPH.

Tuesday, 3 May Methodology

A retrospective chart audit on all patient records (n=48) of stroke wards admissions was carried out between 1 April and 31
September 2014. After excluding overweight patients (BMI >or= 25), those deceased during hospitalisation and records with
incomplete data, 31 records were reviewed. Data collected included: patients’ malnutrition risk, admission BMI, presence of
dysphagia, and requirement of tube feeding, BW change and LOS. Chi-square test and t-test statistics were used to test for
difference between groups.

Results

Of the 31 patients (14 women, mean age of 81 years, range 57-94; 17 men, mean age of 71 years, range 57– 84), 58% (n=18)
patients had UWL (mean weight change -4.1%). The UWL group on admission had a mean BMI of 23.1,SD 2.2 kg/m2, 11% (n=2)
patients at risk of malnutrition, 56% (n=10) had dysphagia, 22% (n=4) required tube feeding, and a median LOS of 27.5 days
(range 10-121). The weight stable group (n=13) on admission had a mean BMI of 20.3,SD 3.4 kg/m2, 15% (n=2) patients at risk
of malnutrition, 46% (n=6) had dysphagia, 8% (n=1) required tube feeding, and a median LOS of 19 days (range 6-51). The
UWL group had significantly higher admission BMI (p=0.011) and longer LOS (p=0.028). The two groups had no significant
difference in percentage patients with malnutrition risk (X2=0.123, p>0.5), dysphagia (X2=1.254, p>0.1) and requiring tube
feeding (X2=1.178, p>0.1).

Conclusion

MST scores did not predict UWL in stroke patients. Additional factors may need to be considered such as anticipated LOS
when screening for nutrition risk of stroke patients on rehabilitation. More patients of higher BMI suffered weight loss in this
study, which was in contrast to a common belief that higher BMI indicates lower malnutrition risk. Further study with larger
sample size is warranted.

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