Impact of ultra-early enteral nutrition on the prognosis of ICU patients with severe traumatic brain injury

XU Bing-jin; BU Wei; MIAO Xi-you; LIU Jie; SHAO Min; TANG Jia-cai

doi:10.13820/j.cnki.gdyx.20242006

Abstract：Objective To investigate whether ultra-early enteral nutrition can improve the 28-day clinical out-comes of patients with severe traumatic brain injury(SBI).Methods Clinical data of ICU patients with SBI from 47 public hospitals in Anhui province from May to June 2022 were collected.Patients who started enteral nutrition within 24 hours of ICU admission were classified as receiving ultra-early enteral nutrition.They were then divided into survival and death groups based on their status at 28 days post-admission.Differences in general data,clinical scores,laboratory in-dicators,and the application of ultra-early enteral nutrition were compared between the groups.A binary logistic regres-sion model was used to identify factors associated with patient mortality,and Kaplan-Meier analysis was performed to compare the 28-day survival rates of patients in the groups of＜24 h,24-48 h and＞48 h initiated enteral nutrition.Results Among the 285 enrolled SBI patients,86 were in the death group and 199 in the survival group.Significant differences were observed between the groups in terms of age,temperature,oxygen saturation,GCS score,APACHE Ⅱscore,SOFA score,platelet count,and application of ultra-early enteral nutrition(P＜0.05).Multi-factor binary lo-gistic regression analysis indicated that ultra-early enteral nutrition is a protective factor for 28-day prognosis in general SBI patients(P=0.013).Kaplan-Meier results demonstrated that the 28-day survival rates of patients intiated with enteral nutrition for 24 to 48 hours was slightly higher than that of patients initiated with enteral nutrition for 24 to 48 hours,and the 28-day survival rate of SBI patients initiated with enteral nutrition for 24 to 48 hours was significantly higher than that of patients initiated with enteral nutrition for＞48 hour with stastistical significunce(P＜0.001).Con-clusion Ultra-early enteral nutrition can improve the nutritional status and reduce the 28-day mortality rate in patients with severe traumatic brain injury.