Nutritional intervention improves prognosis of subarachnoid hemorrhage patients undergoing aneurysmal clipping : a retrospective study

Abstract

Aneurysmal subarachnoid hemorrhage (SAH) is a serious clinical event associated with high mortality and, among survivors, serious morbidity. Maintaining the muscle volume in SAH patients is essential, as rehabilitation is often required after intensive care. In this study, we investigated whether proper nutritional administration improved clinical outcomes based on patients laboratory data and level of activities of daily living. This retrospective study was carried out on 250 consecutive SAH patients who underwent craniotomy within 72 hours of onset from February 2005 to June 2018. Finally, 75 patients with a BMI < 22 kg / m 2 were included. We compared postoperative energy and protein intake in relation to measures of biochemical parameters and modified Rankin Scale at discharge. Serum Alb concentrations at 25-35 hospital days was significantly improved by postoperative energy intake of ≥ 25 kcal / kg and protein intake of ≥ 0.8 g / kg per day beginning 3 days. High serum Alb concentrations at 25-35 hospital days following the start of this intake were independent factors for good prognosis. This study suggests that the minimum postoperative nutritional intake per day for SAH patients undergoing aneurysmal clipping is 25 kcal / kg of energy and 0.8 g / kg of protein. Higher serum Alb concentrations corresponded to improved long-term functional outcome.