Prevalence and risk factors of malnutrition in elderly hospitalized patients with post-stroke dysphagia

Background Stroke has emerged as a major public health issue. Dysphagia affects more than half of stroke survivors and is frequently accompanied by malnutrition, particularly in elderly patients. This study investigated the prevalence and risk factors of malnutrition in elderly stroke patients with dysphagia using a large, nationally representative database. Methods Data were extracted from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) for 2010–2019. Elderly patients (≥ 65 years) with a primary diagnosis of stroke and dysphagia were identified. Descriptive statistics and multivariate logistic regression were used to analyze the association between demographic factors, comorbidities, and malnutrition. Results The overall incidence of malnutrition in elderly stroke patients with dysphagia was 12.5%. Significant risk factors for malnutrition included a higher comorbidity burden, Black race (Odds Ratio [OR] = 1.312), and urban hospital location (OR = 1.160). Key comorbidities associated with malnutrition included fluid-electrolyte disorders (OR = 2.157), coagulopathy (OR = 1.377), and deficiency anemia (OR = 1.603). Malnourished patients had significantly higher mortality rates (9.9% vs 6.9%) and longer hospital stays (median 10 vs. 6 days). Conclusions Malnutrition is prevalent in elderly stroke patients with dysphagia, with a 12.5% incidence. The findings highlight the critical need for early nutritional screening and intervention, particularly in patients with multiple comorbidities, Black race, and those admitted to urban hospitals. Addressing malnutrition in these high-risk patients is essential to improving clinical outcomes, reducing hospital stays, and lowering mortality rates.