Nutritional risk screening 2002 scale and subsequent risk of stroke-associated infection in ischemic stroke: The REMISE study

Abstract

Background and aim: Stroke-associated infection (SAI) is a common and serious complication in patients with IS. This study aimed to evaluate the impact of nutritional status at admission assessed on SAI, explore the predictive value of the Nutritional Risk Screening 2002 (NRS-2002 for SAI. Methods: This study included patients with IS who were admitted to five major hospitals in Chengdu from January 2017 to February 2019. The nutritional status was assessed using the NRS-2002 tool. Logistic regression analysis was performed to explore the predictive value of NRS-2002 for SAI. Results: A total of 594 patients with IS were included in this study; among them, 215 (36.20%) patients were at risk of malnutrition, and 216 (36.36%) patients developed SAI. The area under the curve of the NRS-2002 scores was smaller than A2DS2 (0.644 vs. 0.779), and NRS-2002 improved the predictive values of the A2DS2 score(Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity) for SAI (P < 0.001). Logistic regression analysis showed that patients with NRS-2002 score ≥ 3 had significantly higher risks of SAI (NRS-2002: odds ratios (OR) = 1.450, 95% confidence interval (CI): 1.184–1.692, P < 0.001). Conclusion: NRS-2002 is a useful and simple tool for identifying the risk of SAI. Malnutrition is related to the development of SAI. Malnourished patients with stroke may benefit from further nutritional supplements and management.