Impact of Early, Personalized Nutritional Management on 1-month Mortality After Acute Stroke Pragmatic, Controlled, Multicenter, Cluster-randomized Trial
Impact of Early, Personalized Nutritional Management on 1-month Mortality After Acute Stroke Pragmatic, Controlled, Multicenter, Cluster-randomized Trial
This study evaluate the impact of early personalized nutritional management on 1-month mortality after acute stroke.
In the randomised centres of the interventional group (early personalized nutritional management), each patient will be assessed by a dietician within 2 days of stroke. Any swallowing problems are screened, and any barriers to eating are identified before dietary support. Patient's food intakes are recorded until the 7th day post-acute to assess their energy intake. Depending on patient's nutritional objectives, a reinforced feeding strategy comprising 2 levels is put in place, in order to prevent malnutrition: in level 1, the dietician tries to meet nutritional requirements orally, while in level 2 he can recourse to artificial nutrition in the event of failure or inability to meet requirements with oral intake alone. This strategy is started immediately after the initial assessment. Intakes are reassessed every 24 to 48 hours by the dietician in order to adapt the nutritional strategy as quickly as possible in order to cover the patient's personnalized nutritional needs.
No change in practice was required of the randomised centres in the control group.
All patients will be contacted by telephone 30 days after stroke to collect parts of the assessment criteria, while the other criteria will be collected directly from the patient's computerised medical record.
Three months after stroke, an evaluation of quality of life and modified Rankin test will be performed.
Our hypothesis is that the implementation of an individualized management of early nutritional support, aimed at compensating for the decrease in intake associated with the disease, would reduce mortality at 30 days in patients hospitalised for stroke.
Inclusion Criteria :
Exclusion Criteria:
Angelique.Campion@chu-angers.fr02 41 35 36 37 ext. +33
DRCI-Promotion-Interne@chu-angers.fr02 41 35 36 37 ext. +33
Chesnay, Yvelines 78150, France
lgiboulot@ght78sud.fr01 39 63 89 69 ext. +33
angelique.campion@chu-angers.fr0241353637 ext. +33
deleand-a@chu-caen.fr02 31 06 39 21 ext. +33
dietetique@ch-cholet.fr02 41 49 62 89 ext. +33
elie.guyau@ght85.fr02 51 44 61 61 ext. +33
charlotte.vincent@ght-atlantique17.fr05 46 45 67 62 ext. +33
dietft@ch-chartres.fr02 37 30 36 28
siriane.Landry@chu-rouen.fr02 32 88 89 90 ext. +33
audrey.feltri@chu-nantes.fr02 44 76 84 95 ext. +33
c.barbe@ch-stmalo.fr02 99 21 20 78
geffroyjeremy@gmail.com05 61 77 55 69 ext. +33
p.cheve@chu-tours.fr02 47 47 47 47 ext. +33