Early Personalized Nutritional Support to Reduce 1-Month Mortality After Acute Stroke A Pragmatic, Controlled, Multicenter, Cluster-Randomized Trial

What this Trial Is About

The trial investigates the effect of early personalized nutritional management on the risk of death within one month after an acute stroke. It focuses on patients who have experienced ischemic or hemorrhagic stroke and aims to evaluate whether tailored nutritional support can reduce mortality. The research is led by the University Hospital, Angers, and involves multiple centers using a controlled, randomized design. Patients in the intervention group receive assessment from a dietician within two days of stroke onset. The dietician screens for swallowing difficulties and other eating barriers, recording food intake daily until day 7 post-stroke. Depending on individual nutritional goals, a two-level feeding strategy is applied to prevent malnutrition initial efforts focus on meeting needs orally level 1, and if insufficient, artificial nutrition is introduced level 2. Nutritional intake is reassessed every 24 to 48 hours to adjust the plan promptly. The control group continues usual care without changes. Participants are monitored for mortality at 30 days after stroke, with data collected from medical records and phone interviews. Secondary assessments at 90 days include quality of life and functional status using the modified Rankin Scale. Nutritional status, infection occurrences related to feeding tubes or catheters, and hospital stay duration are also tracked. The total follow-up period extends to three months, allowing comprehensive evaluation of outcomes related to early nutrition management after stroke.

Impact of Early, Personalized Nutritional Management on 1-month Mortality After Acute Stroke