Impact of early enteral nutrition on in-hospital mortality in patients with hypertensive intracerebral hemorrhage

J Korean Neurosurg Soc. 2010 Aug;48(2):99-104. doi: 10.3340/jkns.2010.48.2.99. Epub 2010 Aug 31.

Abstract

Objective: We conducted this study to evaluate the clinical impact of early enteral nutrition (EN) on in-hospital mortality and outcome in patients with critical hypertensive intracerebral hemorrhage (ICH).

Methods: We retrospectively analyzed 123 ICH patients with Glasgow Coma Scale (GCS) score of 3-12. We divided the subjects into two groups : early EN group (< 48 hours, n = 89) and delayed EN group (≥ 48 hours, n = 34). Body weight, total intake and output, serum albumin, C-reactive protein, infectious complications, morbidity at discharge and in-hospital mortality were compared with statistical analysis.

Results: The incidence of nosocomial pneumonia and length of intensive care unit stay were significantly lower in the early EN group than in the delayed EN group (p < 0.05). In-hospital mortality was less in the early EN group than in the delayed EN group (10.1% vs. 35.3%, respectively; p = 0.001). By multivariate analysis, early EN [odds ratio (OR) 0.229, 95% CI : 0.066-0.793], nosocomial pneumonia (OR = 5.381, 95% CI : 1.621-17.865) and initial GCS score (OR = 1.482 95% CI : 1.160-1.893) were independent predictors of in-hospital mortality in patients with critical hypertensive ICH.

Conclusion: These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.

Keywords: Enteral nutrition; Intracerebral hemorrhage; Mortality.