Nutrition Linked to Survival in Traumatic Brain Injury

Patients not fed within five days of traumatic brain injury shown to have twice the risk of mortality

FRIDAY, July 11 (HealthDay News) -- Beginning nutritional support within five days of severe traumatic brain injury is associated with a decrease in two-week mortality, according to research published in the July issue of the Journal of Neurosurgery.

Roger Hartl, M.D., of Weill Cornell Medical College in New York City, and colleagues analyzed data from 797 patients with traumatic brain injury (TBI) and a Glasgow Coma Scale score less than 9. Subjects were treated between 2000 and 2006 in New York trauma centers participating in a program tracking data on TBIs.

The researchers found that any nutrition provided within five days of a TBI is associated with lower mortality. Patients not fed within five and seven days after the injury had, respectively, a two- and fourfold increased chance of mortality. Early nutritional support is one of the few therapies that can directly impact the outcome in such cases, the authors write.

"The mechanism by which nutrition affects outcome is unclear. One possibility is that it may provide important nutrients during a critical time period when demand exceeds available resources. Studies have shown a rise in energy expenditure after TBI, even in paralyzed patients. This hypermetabolic state after TBI may be due to systemic factors such as infection and a post-traumatic stress response, but there appears to be a cerebral component as well. There is an increase in cerebral metabolic rate for glucose in TBI possibly as a result of mitochondrial dysfunction," the authors write.

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