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Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient
Susan D Horn1, Merin Kinikini2, Linda W Moore3
1Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT.
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.
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