Resources and routines for nutritional assessment of patients with severe traumatic brain injury.
OBJECTIVE
To describe the resources and routines for nutritional management until 6 months after severe traumatic brain injury.


METHODS
Data collection was performed by use of questionnaires to staff professionals at three regional neurosurgical intensive and 75 other care units and a retrospective survey of medical and nursing records from 64 patients treated at these units.


RESULTS
Resources in terms of qualified staff members were reportedly good, while nutritional guidelines were adopted in less than half of the units. Screening for malnutrition at admission was rarely performed and the nutritional data in medical and nursing records were incomplete, i.e. there was a lack of body weight measurements in more than one-third of the care unit episodes and of body height data in more than half of the patients and a declining surveillance of energy intake when patients changed from parenteral or enteral nutrition to oral intake. Assessment of energy requirements relied on calculations and the assignment of who was to estimate it varied depending on which nutritional route was used and also between unit specialities. Finally, information on energy requirement, weight development and body mass index was present in only 16%, 7% and in 2% of the transferrals.


CONCLUSIONS
Despite good resources of qualified staff, the nutritional assessment routines were deficient, resulting in incomplete nutritional data and lost nutritional information.
Krakau
Karolina
K
Department of Neuroscience, Rehabilitation Medicine, Uppsala University Hospital, Uppsala, Sweden. karolina.krakau@ds.se
Hansson
Annette
A
Olin
Ann Odlund
AO
Karlsson
Torbjörn
T
de Boussard
Catharina Nygren
CN
Borg
Jörgen
J
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult