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Observational Study
. 2015 Aug;96(8 Suppl):S245-55.
doi: 10.1016/j.apmr.2014.06.024.

Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes

Susan D Horn  1 , Merin Kinikini  2 , Linda W Moore  3 , Flora M Hammond  4 , Murray E Brandstater  5 , Randall J Smout  6 , Ryan S Barrett  6
Affiliations
Observational Study

Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes

Susan D Horn et al. Arch Phys Med Rehabil. 2015 Aug.

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.

Keywords: Brain injuries; Comparative effectiveness research; Enteral nutrition; Propensity score; Rehabilitation.

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Conflict of interest statement

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

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