Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes
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. Pa...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2015-08, Vol.96 (8), p.S245-S255 |
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| creator | Horn, Susan D., PhD Kinikini, Merin, RD, FNP, DNP, CNSC Moore, Linda W., MS, RDN, CCRP Hammond, Flora M., MD Brandstater, Murray E., MD Smout, Randall J., MS Barrett, Ryan S., MS |
| description | 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. |
| doi_str_mv | 10.1016/j.apmr.2014.06.024 |
| format | Article |
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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.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2014.06.024</identifier><identifier>PMID: 26212401</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Brain injuries ; Brain Injuries - rehabilitation ; Brain Injuries - therapy ; Comparative effectiveness research ; Enteral nutrition ; Enteral Nutrition - methods ; Female ; Humans ; Injury Severity Score ; Inpatients ; Length of Stay ; Male ; Middle Aged ; Physical Medicine and Rehabilitation ; Propensity score ; Prospective Studies ; Recovery of Function ; Regression Analysis ; Rehabilitation ; Rehabilitation Centers ; Treatment Outcome</subject><ispartof>Archives of physical medicine and rehabilitation, 2015-08, Vol.96 (8), p.S245-S255</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2015 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-83bc56a30c18e091632ca0dd714c9f29814f79147ff5f690ed727b8d61d7cfbf3</citedby><cites>FETCH-LOGICAL-c455t-83bc56a30c18e091632ca0dd714c9f29814f79147ff5f690ed727b8d61d7cfbf3</cites><orcidid>0000-0001-9257-6100</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.apmr.2014.06.024$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26212401$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horn, Susan D., PhD</creatorcontrib><creatorcontrib>Kinikini, Merin, RD, FNP, DNP, CNSC</creatorcontrib><creatorcontrib>Moore, Linda W., MS, RDN, CCRP</creatorcontrib><creatorcontrib>Hammond, Flora M., MD</creatorcontrib><creatorcontrib>Brandstater, Murray E., MD</creatorcontrib><creatorcontrib>Smout, Randall J., MS</creatorcontrib><creatorcontrib>Barrett, Ryan S., MS</creatorcontrib><title>Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>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.</description><subject>Adult</subject><subject>Brain injuries</subject><subject>Brain Injuries - rehabilitation</subject><subject>Brain Injuries - therapy</subject><subject>Comparative effectiveness research</subject><subject>Enteral nutrition</subject><subject>Enteral Nutrition - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Inpatients</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Propensity score</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>Regression Analysis</subject><subject>Rehabilitation</subject><subject>Rehabilitation Centers</subject><subject>Treatment Outcome</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQxi0EokvhBTggH7kk-E_ixAghlVVbKlW0okVwsxxnwjokzmI7SPtAvCfO7pYDB04ej7_52Z5vEHpJSU4JFW_6XG9HnzNCi5yInLDiEVrRkrOsZvTbY7QihPBMSslP0LMQ-rQVJadP0QkTjLKC0BX6fe4ieD3gT3P0NtrJ4W7y-FZHCy4G_NXGDb73eh5TxuAPXluHr1w_-x1OUdwA_gwb3djBRr0vv4MYrfv-Fp-FMBm7Tx45Ryq-9WAPCO3aB9p6o7026TE2pJvC_uhmjmYaITxHTzo9BHhxXE_Rl4vz-_XH7Prm8mp9dp2ZoixjVvPGlEJzYmgNRFLBmdGkbStaGNkxWdOiqyQtqq4rOyEJtBWrmroVtK1M13T8FL0-cLd--jlDiGq0wcAwaAfTHBQVUhaSlJwkKTtIjZ9C8NCprbej9jtFiVrsUb1a7FGLPYoIlexJRa-O_LkZof1b8uBHErw7CCD98pcFr4JJLTPQWg8mqnay_-e__6fcDNZZo4cfsIPQT7N3qX-KqsAUUXfLgCzzQcsUMFrwP7jtuYc</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Horn, Susan D., PhD</creator><creator>Kinikini, Merin, RD, FNP, DNP, CNSC</creator><creator>Moore, Linda W., MS, RDN, CCRP</creator><creator>Hammond, Flora M., MD</creator><creator>Brandstater, Murray E., MD</creator><creator>Smout, Randall J., MS</creator><creator>Barrett, Ryan S., MS</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9257-6100</orcidid></search><sort><creationdate>20150801</creationdate><title>Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes</title><author>Horn, Susan D., PhD ; Kinikini, Merin, RD, FNP, DNP, CNSC ; Moore, Linda W., MS, RDN, CCRP ; Hammond, Flora M., MD ; Brandstater, Murray E., MD ; Smout, Randall J., MS ; Barrett, Ryan S., MS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-83bc56a30c18e091632ca0dd714c9f29814f79147ff5f690ed727b8d61d7cfbf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Brain injuries</topic><topic>Brain Injuries - rehabilitation</topic><topic>Brain Injuries - therapy</topic><topic>Comparative effectiveness research</topic><topic>Enteral nutrition</topic><topic>Enteral Nutrition - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Inpatients</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Propensity score</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>Regression Analysis</topic><topic>Rehabilitation</topic><topic>Rehabilitation Centers</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horn, Susan D., PhD</creatorcontrib><creatorcontrib>Kinikini, Merin, RD, FNP, DNP, CNSC</creatorcontrib><creatorcontrib>Moore, Linda W., MS, RDN, CCRP</creatorcontrib><creatorcontrib>Hammond, Flora M., MD</creatorcontrib><creatorcontrib>Brandstater, Murray E., MD</creatorcontrib><creatorcontrib>Smout, Randall J., MS</creatorcontrib><creatorcontrib>Barrett, Ryan S., MS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horn, Susan D., PhD</au><au>Kinikini, Merin, RD, FNP, DNP, CNSC</au><au>Moore, Linda W., MS, RDN, CCRP</au><au>Hammond, Flora M., MD</au><au>Brandstater, Murray E., MD</au><au>Smout, Randall J., MS</au><au>Barrett, Ryan S., MS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>96</volume><issue>8</issue><spage>S245</spage><epage>S255</epage><pages>S245-S255</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26212401</pmid><doi>10.1016/j.apmr.2014.06.024</doi><orcidid>https://orcid.org/0000-0001-9257-6100</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Brain injuries Brain Injuries - rehabilitation Brain Injuries - therapy Comparative effectiveness research Enteral nutrition Enteral Nutrition - methods Female Humans Injury Severity Score Inpatients Length of Stay Male Middle Aged Physical Medicine and Rehabilitation Propensity score Prospective Studies Recovery of Function Regression Analysis Rehabilitation Rehabilitation Centers Treatment Outcome |
| title | Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes |
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