Incidence and influencing factors of malnutrition after severe traumatic brain injury

LIU Xiaoxia; FENG Bo; WANG Cen; SUN Xiaoyan; XU Huizhong; GE Lingyu; YAO Shenghong

doi:10.3639/j.issn.1671-2897.2025.03.019

Abstract：Objective To explore the nutritional status after severe traumatic brain injury(STBI)and analyze its influencing factors on malnutrition.Methods The data of 183 patients with STBI surgery in the hospital were retrospectively analyzed.At 2 weeks after surgery,the nutritional status of patients with STBI surgery was evaluated by subjective global assessment(SGA).According to the evaluation results,the patients were divided into good nutrition group(n=51)and malnutrition group(n=132),and serum nutritional indicators and clinical data were compared,and the related factors affecting postoperative malnutrition in STBI patients were analyzed.Results Among the 183 patients with STBI surgery,51 cases had good nutrition at 2 weeks after surgery,73 cases had suspected or moderate malnutrition,and 59 cases had severe malnutrition.The incidence rate of malnutrition was 72.13%.The levels of serum Hb,Alb and TP in malnutrition group were significantly lower than those in good nutrition group(P<0.05).The age,surgical time,intraoperative blood loss,proportion of postoperative infection,proportion of dysphagia and nasal feeding in malnutrition group were significantly higher(P<0.05)while the BMI,GCS score at admission and proportion of early nutritional support were significantly lower than those in good nutrition group(P<0.05).There were no obvious differences in gender,smoking history,drinking history,comorbidity,cause of injury,and type of head injury between the two groups(P>0.05).Binary Logistic regression analysis suggested that prolonged surgical time,increased intraoperative blood loss,concurrent postoperative infection and dysphagia were risk factors for postoperative malnutrition in patients with STBI(P<0.05),and increased GCS score at admission and early nutritional support were protective factors(P<0.05).Conclusions The incidence rate of postoperative malnutrition in patients with STBI is high.Prolonged surgical time,increased intraoperative blood loss,concurrent postoperative infection,and dysphagia can increase the risk of malnutrition in such patients.Increased GCS score at admission and early nutritional support are protective factors for postoperative malnutrition in such patients.Clinically,it is necessary to pay attention to the monitoring of postoperative nutritional status in patients with STBI and take timely measures to avoid the occurrence of malnutrition.