Malnutrition in Patients With Moderate to Severe Acquired Brain Injury: Prevalence During 4 Weeks of Subacute Rehabilitation

Abstract

BACKGROUND: Malnutrition is associated with high rates of complication, longer hospital stays, and increased morbidity and mortality. Malnutrition defined as undernutrition is common in patients with acquired brain injury (ABI); however, estimates vary remarkably. This study aimed to describe malnutrition at admission and after 4 weeks of subacute inpatient neurorehabilitation in patients with ABI using the new global consensus definition of malnutrition. METHODS: One hundred thirty-three patients with moderate to severe ABI consecutively admitted to a specialized neurorehabilitation hospital within a period of 4 months were screened for inclusion, of which 92 were included. Malnutrition was defined as at least 1 phenotypic criterion (weight loss, low body mass index, low muscle mass) and at least 1 etiologic criterion (reduced food intake, inflammation). Malnutrition on admission and after 4 weeks was compared using the McNemar test. RESULTS:The proportion of patients with malnutrition at admission was 42%, with more men (46%) than women (36%) fulfilling the criteria for malnutrition. The most frequent phenotypic and etiologic criteria were weight loss (56%) and inflammation (74%), respectively. During the 4 weeks of rehabilitation, the proportion of male patients fulfilling the individual criteria "weight loss" (difference, −21.4%) and "inflammation" (difference, −18.9%) decreased significantly; "low muscle mass" decreased borderline significant (difference, −8.9%), whereas "low body mass index" did not change. The proportion of female patients fulfilling individual criteria for malnutrition was stable or increased nonsignificantly. CONCLUSION: Malnutrition was common at admission to neurorehabilitation in patients with moderate to severe ABI, with more men than women fulfilling the criteria for malnutrition. The nutritional status improved after 4 weeks of rehabilitation in male patients, whereas it was largely unchanged in female patients. The results provide the basis for monitoring high-quality nutritional nursing care.

Nutritional interventions and related efforts addressing undernutrition during rehabilitation after acquired brain injury: a scoping review protocol

“…[2][3][4][5] At admission, nearly half of patients fulfil the Global Leadership Initiative on Malnutrition (GLIM) criteria 6 7 and 10% remain undernourished after 4 weeks of rehabilitation. 8 Upon referral to in-hospital rehabilitation, a majority of patients with ABI experience weight loss relative to their weight at admission. Long-term undernutrition is known to persist in about one-third of community-dwelling patients with ABI.…”

Relationship between Nutritional Risk, Clinical and Demographic Characteristics, and Pressure Ulcers in Patients with Severe Acquired Brain Injuries Attending a Rehabilitative Program

“…In addition, few recent reports concerning patients with moderate to severe acquired brain injuries have indicated that malnutrition was common at admission to the intensive rehabilitation unit (IRU) after hospitalization in the intensive care unit (ICU) [11,12]. Thus, an early assessment of nutritional risk is crucial to carry out the needed therapies and to prevent the consequences.…”