Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes

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 HMI 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. (C) 2015 by the American Congress of Rehabilitation Medicine