Early enteral nutrition and clinical outcomes of severe traumatic brain injury patients in acute stage: A multi-center cohort study

Yung-Hsiao Chiang, Dan Ping Chao, Shu Fen Chu, Hui Wen Lin, Shih-Yi Huang, Yi Shian Yeh, Tai-Ngar Lui, Colin W. Binns, Wen-Ta Chiu

研究成果: 雜誌貢獻文章

28 引文 (Scopus)

摘要

Guidelines for patients with severe traumatic brain injury (sTBI) published in 2007 recommend providing early nutrition after trauma. Early enteral nutrition (EN) started within 48h post-injury reduces clinical malnutrition, prevents bacterial translocation from the gastrointestinal tract, and improves outcome in sTBI patients sustaining hypermetabolism and hypercatabolism. The aim of this study was to examine the effect of early EN support on survival rate, Glasgow Coma Scale (GCS) score, and clinical outcome of sTBI patients. Medical records of sTBI patients with GCS scores 4-8 were recruited from 18 hospitals in Taiwan, excluding patients with GCS scores ≤3. During 2002-2010, data from 145 EN patients receiving appropriate calories and nutrients within 48h post-trauma were collected and compared with 152 non-EN controls matched for gender, age, body weight, initial GCS score, and operative status. The EN patients had a greater survival rate and GCS score on the 7th day in the intensive care unit (ICU), and a better outcome at 1 month post-injury. After adjusting for age, gender, initial GCS score, and recruitment period, the non-EN patients had a hazard ratio of 14.63 (95% CI 8.58-24.91) compared with EN patients. The GCS score during the first 7 ICU days was significantly improved among EN patients with GCS scores of 6-8 compared with EN patients with GCS scores of 4-5 and non-EN patients with GCS scores of 6-8. This finding demonstrates that EN within 48h post-injury is associated with better survival, GCS recovery, and outcome among sTBI patients, particularly in those with a GCS score of 6-8.
原文英語
頁(從 - 到)75-80
頁數6
期刊Journal of Neurotrauma
29
發行號1
DOIs
出版狀態已發佈 - 一月 1 2012

指紋

Glasgow Coma Scale
Enteral Nutrition
Cohort Studies
Wounds and Injuries
Traumatic Brain Injury
Intensive Care Units
Survival Rate
Bacterial Translocation
Taiwan
Malnutrition
Medical Records
Gastrointestinal Tract

ASJC Scopus subject areas

  • Clinical Neurology

引用此文

Early enteral nutrition and clinical outcomes of severe traumatic brain injury patients in acute stage : A multi-center cohort study. / Chiang, Yung-Hsiao; Chao, Dan Ping; Chu, Shu Fen; Lin, Hui Wen; Huang, Shih-Yi; Yeh, Yi Shian; Lui, Tai-Ngar; Binns, Colin W.; Chiu, Wen-Ta.

於: Journal of Neurotrauma, 卷 29, 編號 1, 01.01.2012, p. 75-80.

研究成果: 雜誌貢獻文章

Chiang, Yung-Hsiao ; Chao, Dan Ping ; Chu, Shu Fen ; Lin, Hui Wen ; Huang, Shih-Yi ; Yeh, Yi Shian ; Lui, Tai-Ngar ; Binns, Colin W. ; Chiu, Wen-Ta. / Early enteral nutrition and clinical outcomes of severe traumatic brain injury patients in acute stage : A multi-center cohort study. 於: Journal of Neurotrauma. 2012 ; 卷 29, 編號 1. 頁 75-80.
@article{3616ea3abbbc4fe097ad49b782c74951,
title = "Early enteral nutrition and clinical outcomes of severe traumatic brain injury patients in acute stage: A multi-center cohort study",
abstract = "Guidelines for patients with severe traumatic brain injury (sTBI) published in 2007 recommend providing early nutrition after trauma. Early enteral nutrition (EN) started within 48h post-injury reduces clinical malnutrition, prevents bacterial translocation from the gastrointestinal tract, and improves outcome in sTBI patients sustaining hypermetabolism and hypercatabolism. The aim of this study was to examine the effect of early EN support on survival rate, Glasgow Coma Scale (GCS) score, and clinical outcome of sTBI patients. Medical records of sTBI patients with GCS scores 4-8 were recruited from 18 hospitals in Taiwan, excluding patients with GCS scores ≤3. During 2002-2010, data from 145 EN patients receiving appropriate calories and nutrients within 48h post-trauma were collected and compared with 152 non-EN controls matched for gender, age, body weight, initial GCS score, and operative status. The EN patients had a greater survival rate and GCS score on the 7th day in the intensive care unit (ICU), and a better outcome at 1 month post-injury. After adjusting for age, gender, initial GCS score, and recruitment period, the non-EN patients had a hazard ratio of 14.63 (95{\%} CI 8.58-24.91) compared with EN patients. The GCS score during the first 7 ICU days was significantly improved among EN patients with GCS scores of 6-8 compared with EN patients with GCS scores of 4-5 and non-EN patients with GCS scores of 6-8. This finding demonstrates that EN within 48h post-injury is associated with better survival, GCS recovery, and outcome among sTBI patients, particularly in those with a GCS score of 6-8.",
keywords = "early enteral feeding, GCS, initial severity, sTBI, survival rate",
author = "Yung-Hsiao Chiang and Chao, {Dan Ping} and Chu, {Shu Fen} and Lin, {Hui Wen} and Shih-Yi Huang and Yeh, {Yi Shian} and Tai-Ngar Lui and Binns, {Colin W.} and Wen-Ta Chiu",
year = "2012",
month = "1",
day = "1",
doi = "10.1089/neu.2011.1801",
language = "English",
volume = "29",
pages = "75--80",
journal = "Journal of Neurotrauma",
issn = "0897-7151",
publisher = "Mary Ann Liebert Inc.",
number = "1",

}

TY - JOUR

T1 - Early enteral nutrition and clinical outcomes of severe traumatic brain injury patients in acute stage

T2 - A multi-center cohort study

AU - Chiang, Yung-Hsiao

AU - Chao, Dan Ping

AU - Chu, Shu Fen

AU - Lin, Hui Wen

AU - Huang, Shih-Yi

AU - Yeh, Yi Shian

AU - Lui, Tai-Ngar

AU - Binns, Colin W.

AU - Chiu, Wen-Ta

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Guidelines for patients with severe traumatic brain injury (sTBI) published in 2007 recommend providing early nutrition after trauma. Early enteral nutrition (EN) started within 48h post-injury reduces clinical malnutrition, prevents bacterial translocation from the gastrointestinal tract, and improves outcome in sTBI patients sustaining hypermetabolism and hypercatabolism. The aim of this study was to examine the effect of early EN support on survival rate, Glasgow Coma Scale (GCS) score, and clinical outcome of sTBI patients. Medical records of sTBI patients with GCS scores 4-8 were recruited from 18 hospitals in Taiwan, excluding patients with GCS scores ≤3. During 2002-2010, data from 145 EN patients receiving appropriate calories and nutrients within 48h post-trauma were collected and compared with 152 non-EN controls matched for gender, age, body weight, initial GCS score, and operative status. The EN patients had a greater survival rate and GCS score on the 7th day in the intensive care unit (ICU), and a better outcome at 1 month post-injury. After adjusting for age, gender, initial GCS score, and recruitment period, the non-EN patients had a hazard ratio of 14.63 (95% CI 8.58-24.91) compared with EN patients. The GCS score during the first 7 ICU days was significantly improved among EN patients with GCS scores of 6-8 compared with EN patients with GCS scores of 4-5 and non-EN patients with GCS scores of 6-8. This finding demonstrates that EN within 48h post-injury is associated with better survival, GCS recovery, and outcome among sTBI patients, particularly in those with a GCS score of 6-8.

AB - Guidelines for patients with severe traumatic brain injury (sTBI) published in 2007 recommend providing early nutrition after trauma. Early enteral nutrition (EN) started within 48h post-injury reduces clinical malnutrition, prevents bacterial translocation from the gastrointestinal tract, and improves outcome in sTBI patients sustaining hypermetabolism and hypercatabolism. The aim of this study was to examine the effect of early EN support on survival rate, Glasgow Coma Scale (GCS) score, and clinical outcome of sTBI patients. Medical records of sTBI patients with GCS scores 4-8 were recruited from 18 hospitals in Taiwan, excluding patients with GCS scores ≤3. During 2002-2010, data from 145 EN patients receiving appropriate calories and nutrients within 48h post-trauma were collected and compared with 152 non-EN controls matched for gender, age, body weight, initial GCS score, and operative status. The EN patients had a greater survival rate and GCS score on the 7th day in the intensive care unit (ICU), and a better outcome at 1 month post-injury. After adjusting for age, gender, initial GCS score, and recruitment period, the non-EN patients had a hazard ratio of 14.63 (95% CI 8.58-24.91) compared with EN patients. The GCS score during the first 7 ICU days was significantly improved among EN patients with GCS scores of 6-8 compared with EN patients with GCS scores of 4-5 and non-EN patients with GCS scores of 6-8. This finding demonstrates that EN within 48h post-injury is associated with better survival, GCS recovery, and outcome among sTBI patients, particularly in those with a GCS score of 6-8.

KW - early enteral feeding

KW - GCS

KW - initial severity

KW - sTBI

KW - survival rate

UR - http://www.scopus.com/inward/record.url?scp=84863011118&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863011118&partnerID=8YFLogxK

U2 - 10.1089/neu.2011.1801

DO - 10.1089/neu.2011.1801

M3 - Article

C2 - 21534720

AN - SCOPUS:84863011118

VL - 29

SP - 75

EP - 80

JO - Journal of Neurotrauma

JF - Journal of Neurotrauma

SN - 0897-7151

IS - 1

ER -