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Neurocritical Care
Published in: Neurocritical Care 3/2018

01-12-2018 | Review Article

Malnutrition in Stroke Patients: Risk Factors, Assessment, and Management

Authors: Toni Sabbouh, Michel T. Torbey

Published in: Neurocritical Care | Issue 3/2018

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Excerpt

Stroke is the fourth leading cause of death in the USA [1] and one of the major causes of disability generating a massive economic burden [2]. Ischemic strokes account for 65–85% of stroke patients in the Western world, and the rest are hemorrhagic strokes which are more disabling [3]. Only 10–20% of hemorrhagic stroke patients will recover functional independence [4]. In order to improve neurological and cognitive functions of stroke patients, numerous rehabilitation interventions are implemented, including nutritional interventions, in attempt to overcome the metabolic consequences of stroke [5, 6]. …
Literature
1.
Group UCSW. United States cancer statistics: 1999–2012 incidence and mortality web-based report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute. 2015.
2.
op Reimer WS, De Haan R, Rijnders P, Limburg M, Van Den Bos G. The burden of caregiving in partners of long-term stroke survivors. Stroke. 1998;29(8):1605–11.CrossRef
3.
Woodruff TM, Thundyil J, Tang S-C, Sobey CG, Taylor SM, Arumugam TV. Pathophysiology, treatment, and animal and cellular models of human ischemic stroke. Mol Neurodegener. 2011;6(1):1.CrossRef
4.
Takahata H, Tsutsumi K, Baba H, Nagata I, Yonekura M. Early intervention to promote oral feeding in patients with intracerebral hemorrhage: a retrospective cohort study. BMC Neurol. 2011;11(1):6.CrossRefPubMedPubMedCentral
5.
Aquilani R, Sessarego P, Iadarola P, Barbieri A, Boschi F. Nutrition for brain recovery after ischemic stroke an added value to rehabilitation. Nutr Clin Pract. 2011;26(3):339–45.CrossRefPubMed
6.
Davis JP, Wong AA, Schluter PJ, Henderson RD, O’Sullivan JD. Impact of premorbid undernutrition on outcome in stroke patients. Stroke. 2004;35(8):1930–4.CrossRefPubMed
7.
Sánchez-Moreno C, Jiménez-Escrig A, Martín A. Stroke: roles of B vitamins, homocysteine and antioxidants. Nutr Res Rev. 2009;22(01):49–67.CrossRefPubMed
8.
Lamb CA, Parr J, Lamb EI, Warren MD. Adult malnutrition screening, prevalence and management in a United Kingdom hospital: cross-sectional study. Br J Nutr. 2009;102(04):571–5.CrossRefPubMed
9.
Chai J, Chu F, Chow T, Shum N. Prevalence of malnutrition and its risk factors in stroke patients residing in an infirmary. Singap Med J. 2008;49(4):290.
10.
Foley NC, Martin RE, Salter KL, Teasell RW. A review of the relationship between dysphagia and malnutrition following stroke. J Rehabil Med. 2009;41(9):707–13.CrossRefPubMed
11.
Gomes F, Emery PW, Weekes CE. Risk of malnutrition is an independent predictor of mortality, length of hospital stay, and hospitalization costs in stroke patients. J Stroke Cerebrovasc Dis. 2016;25(4):799–806.CrossRefPubMed
12.
Foley NC, Salter KL, Robertson J, Teasell RW, Woodbury MG. Which reported estimate of the prevalence of malnutrition after stroke is valid? Stroke. 2009;40(3):e66–74.CrossRefPubMed
13.
Collaboration FT. Poor nutritional status on admission predicts poor outcomes after stroke observational data from the food trial. Stroke. 2003;34(6):1450–6.CrossRef
14.
Corrigan ML, Escuro AA, Celestin J, Kirby DF. Nutrition in the stroke patient. Nutr Clin Pract. 2011;26(3):242–52.CrossRefPubMed
15.
16.
Wirth R, Smoliner C, Jäger M, Warnecke T, Leischker AH, Dziewas R. Guideline clinical nutrition in patients with stroke. Exp Transl Stroke Med. 2013;5(1):1.CrossRef
17.
Collaboration FT. Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial. Lancet. 2005;365(9461):764–72.CrossRef
18.
Dennis M, Lewis S, Cranswick G, Forbes J. FOOD: a multicentre randomised trial evaluating feeding policies in patients admitted to hospital with a recent stroke. Health technology assessment (Winchester, England). 2006;10(2):iii-iv, ix-x, 1-120.
19.
Westergren A. Nutrition and its relation to mealtime preparation, eating, fatigue and mood among stroke survivors after discharge from hospital-a pilot study. Open Nurs J. 2008;2:15–20.CrossRefPubMedPubMedCentral
20.
Scharver CH, Hammond CS, Goldstein LB. Post-stroke malnutrition and dysphagia. Handbook of clinical nutrition and aging. Berlin: Springer; 2009. p. 479–97.
21.
Yang JS, Wang SS, Zhou XY, Chen ZL, Liu CF, Shen YP, et al. The risk factors for malnutrition in post-stroke patients. Zhonghua nei ke za zhi. 2009;48(12):1016–8.PubMed
22.
Ha L, Hauge T, Iversen PO. Body composition in older acute stroke patients after treatment with individualized, nutritional supplementation while in hospital. BMC Geriatr. 2010;10(1):1.CrossRef
23.
Hilker R, Poetter C, Findeisen N, Sobesky J, Jacobs A, Neveling M, et al. Nosocomial pneumonia after acute stroke implications for neurological intensive care medicine. Stroke. 2003;34(4):975–81.CrossRefPubMed
24.
Crary MA, Humphrey JL, Carnaby-Mann G, Sambandam R, Miller L, Silliman S. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care. Dysphagia. 2013;28(1):69–76.CrossRefPubMed
25.
Mould J. Nurses ‘must’ control of the nutritional needs of stroke patients. Br J Nurs. 2009;18(22):1410–4.CrossRefPubMed
26.
Badjatia N, Fernandez L, Schlossberg MJ, Schmidt JM, Claassen J, Lee K, et al. Relationship between energy balance and complications after subarachnoid hemorrhage. J Parenter Enter Nutr. 2010;34(1):64–9.CrossRef
27.
Badjatia N, Monahan A, Carpenter A, Zimmerman J, Schmidt JM, Claassen J, et al. Inflammation, negative nitrogen balance, and outcome after aneurysmal subarachnoid hemorrhage. Neurology. 2015;84(7):680–7.CrossRefPubMedPubMedCentral
28.
Jensen GL, Mirtallo J, Compher C, Dhaliwal R, Forbes A, Grijalba RF, et al. Adult starvation and disease-related malnutrition a proposal for etiology-based diagnosis in the clinical practice setting from the international consensus guideline committee. J Parenter Enter Nutr. 2010;34(2):156–9.CrossRef
29.
Finestone HM, Greene-Finestone LS, Foley NC, Woodbury MG. Measuring longitudinally the metabolic demands of stroke patients resting energy expenditure is not elevated. Stroke. 2003;34(2):502–7.CrossRefPubMed
30.
Bardutzky J, Georgiadis D, Kollmar R, Schwab S. Energy expenditure in ischemic stroke patients treated with moderate hypothermia. Intensive Care Med. 2004;30(1):151–4.CrossRefPubMed
31.
Bouziana SD, Tziomalos K. Malnutrition in patients with acute stroke. J Nutr Metab. 2011;2011:167898.
32.
Dávalos A, Ricart W, Gonzalez-Huix F, Soler S, Marrugat J, Molins A, et al. Effect of malnutrition after acute stroke on clinical outcome. Stroke. 1996;27(6):1028–32.CrossRefPubMed
33.
Romero FR, Cataneo DC, Cataneo AJM. C-reactive protein and vasospasm after aneurysmal subarachnoid hemorrhage1. Acta Cir Bras. 2014;29(5):340–5.CrossRefPubMed
34.
Turner CL, Budohoski K, Smith C, Hutchinson PJ, Kirkpatrick PJ. Elevated baseline C-reactive protein as a predictor of outcome after aneurysmal subarachnoid hemorrhage: data from the simvastatin in aneurysmal subarachnoid hemorrhage (STASH) trial. Neurosurgery. 2015;77(5):786.CrossRefPubMedPubMedCentral
35.
Hankey GJ, Ford AH, Yi Q, Eikelboom JW, Lees KR, Chen C, et al. Effect of B vitamins and lowering homocysteine on cognitive impairment in patients with previous stroke or transient ischemic attack a prespecified secondary analysis of a randomized, placebo-controlled trial and meta-analysis. Stroke. 2013;44(8):2232–9.CrossRefPubMed
36.
Elia M. The’MUST’report. Nutritional screening for adults: a multidisciplinary responsibility. Development and use of the’Malnutrition Universal Screening Tool’(MUST) for adults: British Association for Parenteral and Enteral Nutrition (BAPEN); 2003.
37.
Hookway C, Gomes F, Weekes CE. Royal College of Physicians Intercollegiate Stroke Working Party evidence-based guidelines for the secondary prevention of stroke through nutritional or dietary modification. J Human Nutr Diet Off J Br Diet Assoc. 2015;28(2):107–25.CrossRef
38.
Dworzynski K, Ritchie G, Playford ED. Stroke rehabilitation: long-term rehabilitation after stroke. Clin Med (London, England). 2015;15(5):461–4.CrossRef
39.
Stratton RJ, King CL, Stroud MA, Jackson AA, Elia M. ‘Malnutrition Universal Screening Tool’predicts mortality and length of hospital stay in acutely ill elderly. Br J Nutr. 2006;95(02):325–30.CrossRefPubMed
40.
Lim SL, Ong KCB, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31(3):345–50.CrossRefPubMed
41.
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415–21.CrossRefPubMed
42.
43.
Kasuya H, Kawashima A, Namiki K, Shimizu T, Takakura K. Metabolic profiles of patients with subarachnoid hemorrhage treated by early surgery. Neurosurgery. 1998;42(6):1268–74.CrossRefPubMed
44.
McClave SA, McClain CJ, Snider HL. Should indirect calorimetry be used as part of nutritional assessment? J Clin Gastroenterol. 2001;33(1):14–9.CrossRefPubMed
45.
Bursztein S, Saphar P, Singer P, Elwyn DH. A mathematical analysis of indirect calorimetry measurements in acutely ill patients. Am J Clin Nutr. 1989;50(2):227–30.CrossRefPubMed
46.
Harris JA, Benedict FG. Biometric study of basal metabolism in man: Carnegie Instit.; 2010.
47.
Weekes E, Elia M. Resting energy expenditure and body composition following cerebro-vascular accident. Clin Nutr. 1992;11(1):18–22.CrossRefPubMed
48.
Leone A, Pencharz PB. Resting energy expenditure in stroke patients who are dependent on tube feeding: A pilot study. Clin Nutr. 2010;29(3):370–2.CrossRefPubMed
49.
Illner K, Brinkmann G, Heller M, Bosy-Westphal A, Müller MJ. Metabolically active components of fat free mass and resting energy expenditure in nonobese adults. Am J Physiol Endocrinol Metab. 2000;278(2):E308–15.CrossRefPubMed
50.
Gariballa SE, Parker SG, Taub N, Castleden CM. Influence of nutritional status on clinical outcome after acute stroke. Am J Clin Nutr. 1998;68(2):275–81.CrossRefPubMed
51.
Koukiasa P, Bitzani M, Papaioannou V, Pnevmatikos I. Resting energy expenditure in critically ill patients with spontaneous intracranial hemorrhage. J Parenter Enter Nutr. 2015;39(8):917–21.CrossRef
52.
Esper DH, Coplin WM, Carhuapoma JR. Energy expenditure in patients with nontraumatic intracranial hemorrhage. J Parenter Enter Nutr. 2006;30(2):71–5.CrossRef
53.
Piek J, Zanke T, Sprick C, Bock W. Resting energy expenditure in patients with isolated head injuries and spontaneous intracranial haemorrhages. Clin Nutr. 1989;8(6):347–51.CrossRefPubMed
54.
Moussouttas M, Lai EW, Dombrowski K, Huynh TT, Khoury J, Carmona G, et al. CSF catecholamine profile in subarachnoid hemorrhage patients with neurogenic cardiomyopathy. Neurocrit Care. 2011;14(3):401–6.CrossRefPubMed
55.
Smith SE, Prosser-Loose EJ, Colbourne F, Paterson PG. Protein-energy malnutrition alters thermoregulatory homeostasis and the response to brain ischemia. Current neurovascular research. 2011;8(1):64–74.CrossRefPubMed
56.
Yoo S-H, Kim JS, Kwon SU, Yun S-C, Koh J-Y, Kang D-W. Undernutrition as a predictor of poor clinical outcomes in acute ischemic stroke patients. Arch Neurol. 2008;65(1):39–43.CrossRefPubMed
57.
Shen H-C, Chen H-F, Peng L-N, Lin M-H, Chen L-K, Liang C-K, et al. Impact of nutritional status on long-term functional outcomes of post-acute stroke patients in Taiwan. Arch Gerontol Geriatr. 2011;53(2):e149–52.CrossRefPubMed
58.
Nishioka S, Okamoto T, Takayama M, Urushihara M, Watanabe M, Kiriya Y, et al. Malnutrition risk predicts recovery of full oral intake among older adult stroke patients undergoing enteral nutrition: Secondary analysis of a multicentre survey (the APPLE study). Clinical Nutrition. 2016.
59.
Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010;58(9):1734–8.CrossRefPubMed
60.
Nishioka S, Takayama M, Watanabe M, Urushihara M, Kiriya Y, Hijioka S. Prevalence of malnutrition in convalescent rehabilitation wards in Japan and correlation of malnutrition with ADL and discharge outcome in elderly stroke patients. Nihon Jomyaku Keicho Eiyo Gakkai Zashi. 2015;30:1145–51.
61.
Paquereau J, Allart E, Romon M, Rousseaux M. The long-term nutritional status in stroke patients and its predictive factors. J Stroke Cerebrovasc Dis. 2014;23(6):1628–33.CrossRefPubMed
62.
Nishioka S, Wakabayashi H, Nishioka E, Yoshida T, Mori N, Watanabe R. Nutritional improvement correlates with recovery of activities of daily living among malnourished elderly stroke patients in the convalescent stage: a cross-sectional study. J Acad Nutr Diet. 2016;116(5):837–43.CrossRefPubMed
63.
Prosser-Loose EJ, Verge VMK, Cayabyab FS, Paterson PG. Protein-energy malnutrition alters hippocampal plasticity-associated protein expression following global ischemia in the gerbil. Current neurovascular research. 2010;7(4):341–60.CrossRefPubMed
64.
Nip W, Perry L, McLaren S, Mackenzie A. Dietary intake, nutritional status and rehabilitation outcomes of stroke patients in hospital. J Human Nutr Diet. 2011;24(5):460–9.CrossRef
65.
Hinchey JA, Shephard T, Furie K, Smith D, Wang D, Tonn S, et al. Formal dysphagia screening protocols prevent pneumonia. Stroke. 2005;36(9):1972–6.CrossRefPubMed
66.
Ramsey DJ, Smithard DG, Kalra L. Early assessments of dysphagia and aspiration risk in acute stroke patients. Stroke. 2003;34(5):1252–7.CrossRefPubMed
67.
Bours GJ, Speyer R, Lemmens J, Limburg M, De Wit R. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs. 2009;65(3):477–93.CrossRefPubMed
68.
Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, et al. Dysphagia bedside screening for acute-stroke patients. The Gugging Swallowing Screen. Stroke. 2007;38(11):2948–52.CrossRefPubMed
69.
Warnecke T, Teismann I, Meimann W, Oelenberg S, Zimmermann J, Krämer C, et al. Assessment of aspiration risk in acute ischemic stroke—evaluation of the simple swallowing provocation test. J Neurol Neurosurg Psychiatr. 2008;79(3):312–4.CrossRef
70.
Falsetti P, Acciai C, Palilla R, Bosi M, Carpinteri F, Zingarelli A, et al. Oropharyngeal dysphagia after stroke: incidence, diagnosis, and clinical predictors in patients admitted to a neurorehabilitation unit. J Stroke Cerebrovasc Dis. 2009;18(5):329–35.CrossRefPubMed
71.
Dziewas R, Ritter M, Schilling M, Konrad C, Oelenberg S, Nabavi D, et al. Pneumonia in acute stroke patients fed by nasogastric tube. J Neurol Neurosurg Psychiatr. 2004;75(6):852–6.CrossRef
72.
Gmeinwieser J, Golder W, Lehner K, Bartels H. X-ray diagnosis of the upper gastrointestinal tract at risk for aspiration using a nonionic iso-osmolar contrast medium. Rontgenpraxis; Zeitschrift fur radiologische Technik. 1988;41(10):361–6.PubMed
73.
Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93–8.CrossRefPubMed
74.
Warnecke T, Teismann I, Oelenberg S, Hamacher C, Ringelstein EB, Schäbitz WR, et al. The safety of fiberoptic endoscopic evaluation of swallowing in acute stroke patients. Stroke. 2009;40(2):482–6.CrossRefPubMed
75.
Kelly AM, Drinnan MJ, Leslie P. Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? The Laryngoscope. 2007;117(10):1723–7.CrossRefPubMed
76.
Carnaby G, Hankey GJ, Pizzi J. Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial. Lancet Neurol. 2006;5(1):31–7.CrossRefPubMed
77.
Smithard DG, O’Neill PA, England RE, Park CL, Wyatt R, Martin DF, et al. The natural history of dysphagia following a stroke. Dysphagia. 1997;12(4):188–93.CrossRefPubMed
78.
Mamun K, Lim J. Role of nasogastric tube in preventing aspiration pneumonia in patients with dysphagia. Singap Med J. 2005;46(11):627.
79.
Finestone HM, Greene-Finestone LS, Wilson ES, Teasell RW. Prolonged length of stay and reduced functional improvement rate in malnourished stroke rehabilitation patients. Arch Phys Med Rehabil. 1996;77(4):340–5.CrossRefPubMed
80.
Strong RM, Condon SC, Solinger MR, Namihas BN, Ito-Wong LA, Leuty JE. Equal aspiration rates from postpylorus and intragastric-placed small-bore nasoenteric feeding tubes: a randomized, prospective study. J Parenter Enter Nutr. 1992;16(1):59–63.CrossRef
81.
82.
Care NCCfA. Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. 2006.
83.
Loeb MB, Becker M, Eady A, Walker-Dilks C. Interventions to prevent aspiration pneumonia in older adults: a systematic review. J Am Geriatr Soc. 2003;51(7):1018–22.CrossRefPubMed
84.
Kostadima E, Kaditis A, Alexopoulos E, Zakynthinos E, Sfyras D. Early gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients. Eur Respir J. 2005;26(1):106–11.CrossRefPubMed
85.
Gomes F, Hookway C, Weekes C. Royal College of Physicians Intercollegiate Stroke Working Party evidence-based guidelines for the nutritional support of patients who have had a stroke. J Human Nutr Diet. 2014;27(2):107–21.CrossRef
86.
Körner U, Bondolfi A, Bühler E, Macfie J, Meguid M, Messing B, et al. Ethical and legal aspects of enteral nutrition. Clin Nutr. 2006;25(2):196–202.CrossRefPubMed
87.
Peschl L, Zeilinger M, Munda W, Prem H, Schragel D. Percutaneous endoscopic gastrostomy–a possibility for enteral feeding of patients with severe cerebral dysfunctions. Wien Klin Wochenschr. 1988;100(10):314–8.PubMed
88.
Norton B, Homer-Ward M, Donnelly MT, Long RG, Holmes GK. A randomised prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ (Clin Res ed). 1996;312(7022):13–6.CrossRef
89.
Beavan J, Conroy SP, Harwood R, Gladman JR, Leonardi-Bee J, Sach T, et al. Does looped nasogastric tube feeding improve nutritional delivery for patients with dysphagia after acute stroke? A randomised controlled trial. Age Ageing. 2010;39(5):624–30.CrossRefPubMed
90.
Rhoney DH, Parker Jr D, Formea CM, Yap C, Coplin WM. Tolerability of bolus versus continuous gastric feeding in brain-injured patients. Neurol Res. 2002.Sep; 24(6):613-20
91.
Leder SB, Suiter DM. Effect of nasogastric tubes on incidence of aspiration. Arch Phys Med Rehabil. 2008;89(4):648–51.CrossRefPubMed
92.
Bágyi K, Haczku A, Márton I, Szabó J, Gáspár A, Andrási M, et al. Role of pathogenic oral flora in postoperative pneumonia following brain surgery. BMC Infect Dis. 2009;9(1):104.CrossRefPubMedPubMedCentral
93.
Abe S, Ishihara K, Adachi M, Okuda K. Oral hygiene evaluation for effective oral care in preventing pneumonia in dentate elderly. Arch Gerontol Geriatr. 2006;43(1):53–64.CrossRefPubMed
94.
Chan EY. Oral decontamination for ventilator-associated pneumonia prevention. Aust Crit Care. 2009;22(1):3–4.CrossRefPubMed
95.
Vivanti A, Campbell K, Suter M, Hannan-Jones M, Hulcombe J. Contribution of thickened drinks, food and enteral and parenteral fluids to fluid intake in hospitalised patients with dysphagia. J Human Nutr Diet. 2009;22(2):148–55.CrossRef
96.
Collaboration FT. Routine oral nutritional supplementation for stroke patients in hospital (FOOD): a multicentre randomised controlled trial. Lancet. 2005;365(9461):755–63.CrossRef
97.
Torbey MT, Bösel J, Rhoney DH, Rincon F, Staykov D, Amar AP, et al. Evidence-based guidelines for the management of large hemispheric infarction. Neurocrit Care. 2015;22(1):146–64.CrossRefPubMed
98.
Blaser AR, Starkopf J, Alhazzani W, Berger MM, Casaer MP, Deane AM, et al. Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med. 2017;43(3):380–98.CrossRef
99.
Connolly ES, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. Stroke. 2012:STR. 0b013e3182587839.
100.
Taylor BE, McClave SA, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Crit Care Med. 2016;44(2):390–438.CrossRefPubMed
101.
Jauch EC, Saver JL, Adams HP, Bruno A, Demaerschalk BM, Khatri P, et al. Guidelines for the early management of patients with acute ischemic stroke. Stroke. 2013;44(3):870–947.CrossRefPubMed
102.
Hemphill JC, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, et al. Guidelines for the management of spontaneous intracerebral hemorrhage. Stroke. 2015;46(7):2032–60.CrossRefPubMed
Metadata
Title
Malnutrition in Stroke Patients: Risk Factors, Assessment, and Management
Authors
Toni Sabbouh
Michel T. Torbey
Publication date
01-12-2018
Publisher
Springer US
Published in
Neurocritical Care / Issue 3/2018
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-017-0436-1

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