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Time interval of oral feeding recovery as a prognostic factor in severe traumatic brain injury
R Formisano1, R D Voogt, M G Buzzi
1IRCCS Fondazione Santa Lucia, Rome, Italy. r.formisano@hsantalucia.it
Insights
Early indicators during coma recovery, such as safe oral feeding, significantly predict long-term outcomes for severe traumatic brain injury patients. These prognostic factors aid in assessing recovery trajectories.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Clinical Neurology
Background:
- Severe traumatic brain injury (TBI) often results in prolonged coma.
- Predicting long-term outcomes in these patients is crucial for rehabilitation planning.
Purpose of the Study:
- To evaluate the 1-year outcome of severe TBI patients.
- To identify early clinical prognostic factors during coma recovery that correlate with long-term outcomes.
Main Methods:
- Retrospective study of 43 severe TBI patients with prolonged coma (≥15 days).
- Outcome assessment at 1 year using Glasgow Coma Scale, Barthel Index, and Mini Mental State.
- Analysis of early prognostic factors during coma recovery, including optical fixation, obeying commands, motor activity, and oral feeding.
Main Results:
- Statistically significant correlations found between recovery time of specific clinical variables and 1-year outcomes (Glasgow Outcome Scale, Barthel Index).
- Favorable prognostic factors identified: optical fixation, obeying commands, spontaneous motor activity, first safe oral feeding, psychomotor agitation, and bulimia.
- First safe oral feeding emerged as a strong predictor of final outcome.
Conclusions:
- Early safe oral feeding during coma recovery is a key predictor for severe TBI patients.
- Identifying these prognostic factors can optimize clinical management and rehabilitation strategies for TBI survivors.
Primary Objectives:
To assess the outcome of severe traumatic brain injury at least 1 year after trauma, in relation to some early clinical prognostic factors occurring during coma recovery.
Research Design:
Retrospective study conducted at the post-coma unit of a rehabilitation hospital.
Methods And Procedures:
A total of 43 patients were included. All of the patients sustained severe traumatic brain injury and prolonged coma, i.e. coma lasting at least 15 days. Outcome was assessed by means of Glasgow Coma Scale, Barthel Index and Mini Mental State 1 year after trauma, in relation to some early clinical prognostic factors occurring during coma recovery.
Main Outcomes And Results:
At the 1 year follow-up, a statistically significant correlation was found with both the Glasgow Outcome Scale and the Barthel Index for the time interval from brain injury to recovery of the following clinical variables: optical fixation, ability to obey commands, spontaneous motor activity and first safe oral feeding. Psychomotor agitation and bulimia were also favourable prognostic factors for the final outcome.
Conclusions:
In the present study, first safe oral feeding during coma recovery represents the clinical feature that better predicts the final outcome of patients with severe traumatic brain injury and prolonged coma.
