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Journal of Korean Neurosurgical Society 2010;48(2): 99-104.
doi: https://doi.org/10.3340/jkns.2010.48.2.99
Impact of Early Enteral Nutrition on In-Hospital Mortality in Patients with Hypertensive Intracerebral Hemorrhage.
Jeong Shik Lee, Cheol Su Jwa, Hyeong Joong Yi, Hyoung Joon Chun
1Department of Neurosurgery, National Medical Center, Seoul, Korea. chsjwa@hanmail.net
2Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
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).
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 (> or = 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.
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.
These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.
Key Words: Enteral nutrition; Intracerebral hemorrhage; Mortality
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