ABSTRACT
Objective
To systematically evaluate and conduct a meta-analysis on the effects of early nutritional intervention on serum albumin (ALB), hemoglobin (HB), NIH Stroke Scale (NIHSS) scores, and complication rates in stroke patients with dysphagia, providing evidence-based support for clinical rehabilitation management.
Methods
A systematic search was conducted in PubMed, Wiley Library, Cochrane Library, EMBASE, and Web of Science databases from inception to April 25, 2025 (the final search date). The search strategy was designed and executed by an experienced medical librarian and one investigator. Retrieved records were imported into EndNote X20 (Clarivate Analytics) for reference management and duplicate removal. Two researchers independently performed the subsequent literature screening, data extraction, and risk of bias assessment. Meta-analysis was conducted using Review Manager 5.4, and publication bias was assessed using Stata 16.0.
Results
A total of 13 multicenter RCTs were included. The meta-analysis indicated that the early nutritional intervention group showed significantly higher post-intervention serum albumin levels (SMD = 2.08, 95% CI: 1.36–2.80, p < 0.00001) and hemoglobin levels (SMD = 1.74, 95% CI: 1.04–2.45, p < 0.00001) compared to the control group; post-intervention NIHSS scores were also significantly lower in the intervention group (MD = −2.68, 95% CI: −3.20 to −2.16, p < 0.00001); the incidence of complications was also significantly reduced (OR = 0.31, 95% CI: 0.19–0.53, p < 0.0001). Sensitivity analysis showed stable results, and no significant publication bias was detected except for NIHSS scores.
Conclusion
Early nutritional intervention is associated with significant improvements in key biochemical parameters, neurological deficit, and complication rates in stroke patients with dysphagia, demonstrating positive clinical application value. Future research should focus on more high-quality, large-sample RCTs to further validate these findings and explore optimal intervention strategies.
Journal of Human Nutrition and Dietetics, Volume 38, Issue 6, December 2025. Read More