Susan D Horn1, Merin Kinikini2, Linda W Moore3, Flora M Hammond4, Murray E Brandstater5, Randall J Smout6, Ryan S Barrett6. 1. Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT. Electronic address: susan.horn@hsc.utah.edu. 2. Neuro Specialty Rehabilitation Unit, Intermountain Medical Center, Salt Lake City, UT. 3. Houston Methodist Hospital, Houston, TX. 4. Carolinas Rehabilitation, Charlotte, NC; Indiana University, Indianapolis, IN. 5. Loma Linda University Medical Center, Loma Linda, CA. 6. Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT.
Abstract
OBJECTIVE: To determine the association of enteral nutrition (EN) with patient preinjury and injury characteristics and outcomes for patients receiving inpatient rehabilitation after traumatic brain injury (TBI). DESIGN: Prospective observational study. SETTING: Nine rehabilitation centers. PARTICIPANTS: Patients (N=1701) admitted for first full inpatient rehabilitation after TBI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FIM at rehabilitation discharge, length of stay, weight loss, and various infections. RESULTS: There were many significant differences in preinjury and injury characteristics between patients who received EN and patients who did not. After matching patients with a propensity score of >40% for the likely use of EN, patients receiving EN with either a standard or a high-protein formula (>20% of calories coming from protein) for >25% of their rehabilitation stay had higher FIM motor and cognitive scores at rehabilitation discharge and less weight loss than did patients with similar characteristics not receiving EN. CONCLUSIONS: For patients receiving inpatient rehabilitation after TBI and matched on a propensity score of >40% for the likely use of EN, clinicians should strongly consider, when possible, EN for ≥25% of the rehabilitation stay and especially with a formula that contains at least 20% protein rather than a standard formula.
OBJECTIVE: To determine the association of enteral nutrition (EN) with patient preinjury and injury characteristics and outcomes for patients receiving inpatient rehabilitation after traumatic brain injury (TBI). DESIGN: Prospective observational study. SETTING: Nine rehabilitation centers. PARTICIPANTS: Patients (N=1701) admitted for first full inpatient rehabilitation after TBI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FIM at rehabilitation discharge, length of stay, weight loss, and various infections. RESULTS: There were many significant differences in preinjury and injury characteristics between patients who received EN and patients who did not. After matching patients with a propensity score of >40% for the likely use of EN, patients receiving EN with either a standard or a high-protein formula (>20% of calories coming from protein) for >25% of their rehabilitation stay had higher FIM motor and cognitive scores at rehabilitation discharge and less weight loss than did patients with similar characteristics not receiving EN. CONCLUSIONS: For patients receiving inpatient rehabilitation after TBI and matched on a propensity score of >40% for the likely use of EN, clinicians should strongly consider, when possible, EN for ≥25% of the rehabilitation stay and especially with a formula that contains at least 20% protein rather than a standard formula.
Authors: Richard E Kennedy; Lee Livingston; Jennifer H Marwitz; Shana Gueck; Jeffrey S Kreutzer; Angelle M Sander Journal: J Head Trauma Rehabil Date: 2006 May-Jun Impact factor: 2.710
Authors: Jose Acosta-Escribano; Miguel Fernández-Vivas; Teodoro Grau Carmona; Juan Caturla-Such; Miguel Garcia-Martinez; Ainhoa Menendez-Mainer; Manuel Solera-Suarez; José Sanchez-Payá Journal: Intensive Care Med Date: 2010-05-22 Impact factor: 17.440