Persons with disorders of consciousness: are oral feedings safe/effective?
OBJECTIVE
Evaluate the safety and efficacy of providing oral feedings to persons early in coma recovery following a severe brain injury.


METHODS
Descriptive, retrospective study.


METHODS
Medical chart reviews of all patients admitted to a rehabilitation hospital following severe brain injury.


RESULTS
Twenty-five patients met the inclusion criteria, 22 had a tracheostomy, and all were NPO. Subjects were divided into two cohorts. Group 1, n=10, mean age 43.5 years, received oral feedings early in coma recovery. Group 2, n=15, mean age 45.2 years, did not. Group 1, 30% returned to an oral diet of three meals daily at discharge from inpatient rehabilitation as compared to 40% in group 2 (chi2 = 0.260, p = 0.610). Average cost of care for group 1 = US$45 759 and group 2 = US$41 056 (p = 0.634).


CONCLUSIONS
Safe therapeutic oral feedings, in accordance with findings from instrumental swallowing examinations, are possible for patients with disordered consciousness. The therapeutic oral feedings do not significantly increase the cost of care, but the effectiveness of oral feedings early in coma recovery requires further investigation.
Brady
Susan L
SL
Marianjoy Rehabilitation Hospital, 26 W 171 Roosevelt Road, Wheaton, Illinois 60187, USA. sbrady@marianjoy.org
Darragh
Meghan
M
Escobar
Nelson G
NG
O'Neil
Kara
K
Pape
Theresa L B
TL
Rao
Noel
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D016022:Case-Control Studies; D020207:Coma, Post-Head Injury / Q000534:rehabilitation; D003244:Consciousness Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D003679:Deglutition; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies