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Predictive Value of Nutritional Risk for All-Cause Death and Functional Outcomes in Chinese Elderly Patients with Acute Stroke: A 3-Year Follow-Up Study [Letter]

Authors Qiu X, Nong Y

Received 13 February 2024

Accepted for publication 5 March 2024

Published 7 March 2024 Volume 2024:19 Pages 399—400


Checked for plagiarism Yes

Editor who approved publication: Dr Maddalena Illario

Xiaoqin Qiu,1 Yuechou Nong2

1Department of Nursing, The Guangxi Hospital of the First Affiliated Hospital of Sun Yat-sen University, Nanning, Guangxi, 530021, People’s Republic of China; 2Department of Endocrinology and Metabolism, The Guangxi Academy of Medical Sciences, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of China

Correspondence: Yuechou Nong, Email [email protected]

View the original paper by Professor Cong and colleagues

Dear editor

Newly, we had paid attention to the published paper entitled “Predictive Value of Nutritional Risk for All-Cause Death and Functional Outcomes in Chinese Elderly Patients with Acute Stroke: A 3-Year Follow-Up Study” by Cong WJ team in Clinical Interventions in Aging.1 We appreciate this study and congratulate them on their performance.

This study explored the predictive value of nutritional risk for all-cause mortality and functional outcomes in elderly patients with acute stroke. Based on the nutritional risk screening 2002 (NRS-2002) and geriatric nutritional risk index (GNRI), the primary all-cause mortality endpoint event and the secondary poor prognosis outcome were assessed in a total of 479 elderly patients with acute stroke. They found that patients with moderate and severe malnutrition had a higher risk of all-cause death at 3 months and at 3 years and a higher risk of adverse functional outcomes at 3 months. They concluded that nutritional risk increased the risk of poor short-term and long-term endpoint events in elderly patients with acute stroke.

We believe that only by improving the following points can the conclusions of this study have a stronger guiding effect on routine clinical practice. Firstly, absence of information on Vitamin D levels in participants. Regardless of conventional risk factors, vitamin D insufficiency, especially its severe form, is related to an elevated risk of cardiovascular events (stroke, coronary heart disease, and mortality).2 Notably, it is pretty typical for older Chinese people to be deficient in vitamin D.3 Additionally, absence of information on bone metabolism. Osteoporosis is a twin disease with stroke.4 Meanwhile, osteosarcopenia caused by decreased appetite is closely related to malnutrition.5

Although we applaud this research work, we still believe that only further improving the research design can obtain more convincing conclusions.


The authors report no conflicts of interest in this communication.


1. Cong WJ, Liu ZP, Liang YX, et al. Predictive value of nutritional risk for all-cause death and functional outcomes in Chinese elderly patients with acute stroke: a 3-year follow-up study. Clin Interventions Aging. 2024;19:109–118. doi:10.2147/CIA.S447038

2. Anagnostis P, Livadas S, Goulis DG, et al. EMAS position statement: vitamin D and menopausal health. Maturitas. 2023;169:2–9. doi:10.1016/j.maturitas.2022.12.006

3. Liu L, Cao Z, Feng L, et al. Vitamin D deficiency and metabolic syndrome in elderly Chinese individuals: evidence from CLHLS. Nutr Metab. 2020;29(17):58. doi:10.1186/s12986-020-00479-3

4. Sennerby U, Melhus H, Gedeborg R, et al. cardiovascular diseases and risk of Hip fracture. JAMA. 2009;302(15):1666–1673. doi:10.1001/jama.2009.1463

5. Chen S-C, Chung W-S, Pei-Yu W, et al. Associations among geriatric nutrition risk index, bone mineral density, body composition and handgrip strength in patients receiving hemodialysis. Nutrition. 2019;65:6–12. doi:10.1016/j.nut.2019.02.013

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