Impact of early protein provision on the mortality of acute critically ill stroke patients

Abstract Background Stroke is the leading cause of death in China, and dysphagia is a common symptom of stroke. For acute critically ill stroke patients, whether the protein provision overwhelming calorie provision impacts the outcome still requires investigation. Materials and Methods We conducted a retrospectively observational study. Acute stroke patients admitted to our neurocritical care unit between January 2013 and January 2017 were enrolled. Primary end points were short‐term (30‐day) and long‐term (6‐month) mortality, as well as long‐term poor outcome with a modified Rankin scale score ≥4. Results Of 208 eligible patients, 127 (61.1%) patients were diagnosed with acute ischemic stroke and 81 (38.9%) with intracranial hemorrhage. In multivariate logistic regression analysis, the increased protein provision was significantly associated with reduced 30‐day and 6‐month mortality ( P = .041 and P = .020, respectively) but not 6‐month functional outcome ( P = .365), whereas calorie provision had no independent association with either mortality or functional outcome. When the protein provision ≤1.74 g/kg/day, there was a 9.37% decrease in short‐term mortality and a 9.21% decrease in long‐term mortality with each 0.1 g/kg/day increase in protein delivery. The patients were further divided into five subgroups based on the amount of protein provision, and Linear‐by‐Linear Association tests showed there was a negative linear relationship between the protein provision and 30‐day and 6‐month mortality ( P = .048 and P = .017, respectively). Conclusions Early protein provision during the first week is an independent predictor of short‐term and long‐term mortality in acute critically ill stroke patients.