Washington, July 2 : Following a traumatic brain injury (TBI), patients should be given nutritional supplementation through a gastric feeding tube as soon as possible, for it can improve their chances of survival by as much as four-fold, suggests a new study.
Clinician-scientists from NewYork-Presbyterian Hospital/Weill Cornell Medical Center are suggesting an immediate addition of the change in guidelines used in the care of patients with TBI.
"The evidence shows that the body heals better when it is given proper nutrition, not just the bare minimum that keeps someone alive," says lead author Dr. Roger Hartl, a noted neurological surgeon at NewYork-Presbyterian/Weill Cornell, and the Leonard and Fleur Harlan Clinical Scholar and assistant professor of neurological surgery at Weill Cornell Medical College.
"Before now, patients were required to have nutritional supplementation within the first week following their injury, but our findings suggest that this is simply not soon enough," he added.
This is the largest study to ever look at the issue of nutrition and survival following TBI.
For the study, the research team followed survival outcome and nutritional care in 797 patients from 2000-2006.
To formulate their findings, the researchers recorded the length of time it took for each patient to receive gastric nutrition and how many calories they ingested.
After controlling for factors like age, high blood pressure, brain pressure, prior neurological and cardiac conditions, and CT scan results shortly after the time of injury, the researchers found that the earlier each patient received a feeding-tube, and the more calories they ingested, the better their likelihood for survival.
Without gastric feeding within the first 5-7 days of suffering their injury, patients had a two- and four-fold higher likelihood of death, respectively. Also, the study reports that every 10kcal/kg decrease in caloric intake was associated with a 30-40 percent increase in mortality rate.
The best outcomes for patients with TBI were observed when patients received a minimum of 25kcal/kg each day.
Alarmingly, the researchers found that as many as 62 percent of the patients studied never met this level of caloric intake.
"I think these findings say a lot about using what we know from basic research and applying the knowledge directly to the care we give to patients," says Dr. Hartl.
The study is published in this month's issue of the Journal of Neurosurgery.