title: Enteral Nutrition for Patients With Traumatic Brain Injury in the Rehabilitation Setting: Associations With Patient Preinjury and Injury Characteristics and Outcomes.
abstract: 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).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Nine rehabilitation centers.
  
  
  METHODS
  Patients (N=1701) admitted for first full inpatient rehabilitation after TBI.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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 FIM 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.
authors.affiliation: Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT. Electronic address: susan.horn@hsc.utah.edu.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
authors.affiliation: Neuro Specialty Rehabilitation Unit, Intermountain Medical Center, Salt Lake City, UT.
authors.forename: Merin
authors.initials: M
authors.lastname: Kinikini
authors.affiliation: Houston Methodist Hospital, Houston, TX.
authors.forename: Linda W
authors.initials: LW
authors.lastname: Moore
authors.affiliation: Carolinas Rehabilitation, Charlotte, NC; Indiana University, Indianapolis, IN.
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.affiliation: Loma Linda University Medical Center, Loma Linda, CA.
authors.forename: Murray E
authors.initials: ME
authors.lastname: Brandstater
authors.affiliation: Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT.
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Smout
authors.affiliation: Institute for Clinical Outcomes Research, International Severity Information Systems, Inc, Salt Lake City, UT.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Barrett
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation* / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012044:Regression Analysis; D012047:Rehabilitation Centers; D016896:Treatment Outcome
keywords: Brain injuries; Comparative effectiveness research; Enteral nutrition; Propensity score; Rehabilitation