LAUSR

ABSTRACT Background Stroke is a leading cause of disability and burden worldwide. Recent studies have highlighted the link between undernutrition and the risk of hemorrhagic transformation in ischemic stroke, indicating that undernutrition may directly affect stroke severity. However, the extent to which nutritional status at stroke onset influences stroke severity remains unclear. Aims This study aimed to investigate the relationship between undernutrition on admission and stroke severity in patients with acute stroke. Methods This retrospective cross-sectional study included hospitalised patients with acute stroke. Nutritional status was determined using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Multiple linear regression analyses identified covariates associated with NIHSS scores, including GLIM-defined undernutrition and risk of undernutrition according to the Mini Nutritional Assessment Short Form and the Geriatric Nutritional Risk Index. Results This study included 563 patients with acute stroke (median age, 81 years). Those with GLIM-defined undernutrition had high NIHSS scores. Multiple regression analysis revealed that GLIM-defined undernutrition (β = 0.136, p = 0.002), risk of undernutrition according to the Mini Nutritional Assessment Short Form (β = 0.160, p < 0.001), and risk of undernutrition according to the Geriatric Nutritional Risk Index (β = 0.081, p = 0.043) were independently associated with increased NIHSS scores. Conclusion The presence or risk of undernutrition at the time of hospital admission is associated with severe stroke in patients with acute stroke. This finding indicates the necessity for further research to understand the impact of nutrition on stroke severity and develop effective prevention strategies.