Does measurement of fluid intake provide an accurate indication of hydration for stroke rehabilitation inpatients?

Purpose: Individuals with dysphagia post-stroke are considered at risk of inadequate oral fluid intake. Recent evidence demonstrates they are also at higher risk of dehydration than their non-dysphagic peers in acute settings. This study examined the oral fluid intake and hydration of individuals without dysphagia post-stroke to determine whether they too are at risk of dehydration and whether measurement of fluid intake is a strong predictor of dehydration. Method(s): This prospective study was conducted in three rehabilitation centres to measure the oral beverage intake and hydration of 86inpatients without dysphagia post stroke. Average beverage intake was calculated from 7 days of fluid balance charts, with biochemical measures of blood urea nitrogen/creatinine ratio (BUN/Cr) taken at the beginning and end of this period. Result(s): The participants drank on average 1,504 ml per day (SD359 ml). The mean BUN/Cr ratio at entry to the study was 19.79(SD = 5.33) and remained stable at day 7 (19.97, SD = 5.55). At these two time points 40 and 44 % of the participants in the sample were dehydrated based on BUN/Cr ratio[20:1. Fluid intake was not correlated with measures of hydration at entry to the study (r = -0.122, p = 0.265) or day 7 (r = -0.1, p = 0.379).Conclusions (including clinical relevance): Measurement of oral fluid intake alone is not adequate in detecting individuals who are dehydrated following stroke. Individuals without dysphagia are also at risk of dehydration in rehabilitation settings therefore all patients hospitalized due to stroke should have their hydration monitored routinely through objective measures. Disclosures: Joanne Murray: Financial Disclosure: Salary: Hampstead Rehabilitation Centre, South Australia; Grant: National Stroke Foundation Clinical Research Development Award Grant of $30,000(Australia); Nonfinancial Disclosure: Society Member: Dysphagia Research Society | Sebastian Doeltgen: Financial Disclosure: Salary: Flinders University, South Australia; Intellectual Property Rights: Flinders University; Nonfinancial Disclosure: Society Member: Dysphagia Research Society | Michelle Miller: Financial Disclosure: Salary: Flinders University, South Australia; Intellectual Property Rights: Flinders University; Nonfinancial Disclosure: No relevant nonfinancial relationships exist. | Ingrid Scholten: Financial Disclosure: Salary: Flinders University, South Australia; Intellectual Property Rights: Flinders University, South Australia; Nonfinancial Disclosure: Society Member: Dysphagia Research Society.