Nutritional Status, Dietary Patterns, and Prealbumin as Prognostic Factors in Stroke: An Observational Study

Introduction: Prealbumin is a protein synthesized by the choroid plexus and liver, playing integral roles in the transport of thyroxine and retinol. Its serum levels are known to decrease in response to conditions such as inflammation, protein deficiency, end-stage liver disease, and malignancy. Notably, decreased serum prealbumin levels have been negatively correlated with the severity of stroke. Given this context, understanding factors that predict functional outcomes and mortality in stroke patients is crucial, particularly the potential role of nutritional status and prealbumin levels. Methods: This study targeted a patient population aged 18 to 100 years who were treated for stroke. We systematically recorded levels of prealbumin, albumin, hemoglobin, and the BUN/Cre ratio at three time intervals: on admission, the 5th day, and the 9th day post-admission. In addition, we assessed the severity and functional outcomes using the NIHSS and mRS scores at admission, the 9th day, and upon discharge. Other recorded parameters included Body Mass Index (BMI), daily caloric requirements, NRS-2002 nutritional risk screening scores, chronic disease presence, length of hospital stay, history of infarction, TOAST classification, and dietary patterns. Our study included a total of 57 patients. Results: Our findings indicate that there was no significant difference in age between nonsurviving and surviving stroke patients, although deceased patients tended to be older. Notably, prealbumin and albumin levels were significantly higher in surviving patients (p < 0.05). The BUN/Cre ratio showed no difference between the groups at the time of admission, but its values on the 5th and 9th days were significantly elevated in nonsurvivors (p < 0.01). Furthermore, our analysis revealed that an increase in prealbumin and albumin levels positively influenced patient outcomes. Conversely, higher BUN/Cre ratios and NIHSS scores were associated with poor outcomes, with these differences reaching statistical significance (p < 0.01). Conclusion: The study established a clear association between prealbumin and albumin levels, the BUN/Cre ratio, NIHSS and mRS scores, and overall nutritional status with the functional outcomes and mortality rates in stroke patients. Our results underscore the importance of closely monitoring nutritional status and these specific biochemical markers as part of the comprehensive management of stroke patients to potentially improve their outcomes. © 2024 BiomedPress. All rights reserved.