Early nutritional support enhances recovery after endovascular thrombectomy: A prospective study with institutional historical control

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-09-26 DOI:10.1016/j.clnu.2025.09.013

Kota Maekawa , Nobuyuki Ohara , Naoki Higashibeppu , Michi Kawamoto , Tsuyoshi Ohta

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引用次数: 0

Abstract

Background & aims

The efficacy of nutritional support in patients after successful endovascular thrombectomy (EVT) remains unclear. This study aimed to determine whether individualized nutritional support through a multidisciplinary team approach could improve the clinical outcomes of patients who underwent EVT.

Methods

This quasi-experimental study with a non-randomized controlled design compared a prospective cohort receiving individualized nutritional support with an institutional historical control cohort receiving standard care. Patients with acute ischemic stroke who underwent successful EVT (mTICI 2b-3) were included, and propensity score matching performed using age, sex, premorbid modified Rankin Scale (mRS) score, and initial National Institutes of Health Stroke Scale score, resulting in 42 matched pairs. The nutritional support group received individualized nutritional support by a multidisciplinary team targeting 30 kcal/kg/day of energy and 1.5 g/kg/day of protein within 7 days post-admission. Achievement was evaluated using two criteria: target achievement (≥70 % of goals of both energy and protein goals) and full target completion (100 % of both goals). The team monitored the swallowing function, metabolic parameters, and adjusted nutrition plans to safely achieve nutritional targets. The primary outcome was mRS score at 90 days.

Results

The nutritional support group exhibited significantly improved 90-day mRS scores across multiple adjusted models (common odds ratio: 2.280–2.820, P < 0.05) and eliminated 90-day mortality (0 % vs. 23.8 %, P = 0.001). Target achievement (66.7 % vs. 31.0 %, P = 0.002) and full target completion (16.7 % vs. 2.4 %, P = 0.057) tended to be higher in the nutritional support group than in the control group. The proportion of complications, including aspiration pneumonia, diarrhea, and hyperglycemia, was comparable to or lower in the nutritional support group than in the control group.

Conclusions

Early individualized nutritional support by a multidisciplinary team safely improves functional outcomes in patients with successful EVT. These findings support the implementation of team-based individualized nutritional support for patients following EVT.

查看原文本刊更多论文

早期营养支持促进血管内血栓切除术后的恢复：一项具有制度历史对照的前瞻性研究

背景和目的营养支持在血管内血栓切除术（EVT）成功后的疗效尚不清楚。本研究旨在确定通过多学科团队方法进行个性化营养支持是否可以改善EVT患者的临床结果。方法本准实验研究采用非随机对照设计，将接受个性化营养支持的前瞻性队列与接受标准治疗的机构历史对照队列进行比较。纳入成功行EVT （mTICI 2b-3）的急性缺血性卒中患者，并使用年龄、性别、病前改良Rankin量表（mRS）评分和美国国立卫生研究院卒中量表初始评分进行倾向评分匹配，得到42对匹配。营养支持组在入院后7天内接受多学科团队的个性化营养支持，目标是30 kcal/kg/天的能量和1.5 g/kg/天的蛋白质。使用两个标准评估成就：目标实现（能量和蛋白质目标的目标≥70%）和完全完成目标（两个目标的100%）。研究小组监测了吞咽功能、代谢参数，并调整了营养计划，以安全地达到营养目标。主要观察指标为90天mRS评分。结果在多个调整模型中，营养支持组90天mRS评分显著提高（常见优势比：2.280 ~ 2.820,P < 0.05），并消除90天死亡率（0% vs. 23.8%, P = 0.001）。营养支持组的目标完成率（66.7%比31.0%,P = 0.002）和完全目标完成率（16.7%比2.4%,P = 0.057）均高于对照组。并发症的比例，包括吸入性肺炎、腹泻和高血糖，营养支持组与对照组相当或更低。结论多学科团队的早期个体化营养支持可安全改善EVT成功患者的功能预后。这些发现支持对EVT患者实施基于团队的个性化营养支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.