Abstract
Head-injured patients are at high risk for malnutrition due to trauma, complications, dysphagia, and other effects of brain damage. Malnutrition in the patient recovering from closed head injury may have a detrimental effect on rehabilitation progress and outcome. Little information is available to date on the incidence, etiology, assessment, or therapy of malnutrition in head-injured patients after the acute phase. Nutrition after closed head injury was assessed by clinical, laboratory, and anthropometric data. Fifty-three consecutive head injury patients were studied on admission and during their rehabilitation stay. Of this group, 60.4% were below 90% of their ideal body weight. The average weight loss from injury to admission was 29 lb. On the average, these patients were 86.9% of their ideal body weight. Furthermore, 31% had a low serum albumin, and 56% of them had dysphagia. Admission body weight had a low predictive value for the discharge functional measures of mobility, activities of daily living, disposition, and assistance needed. The incidence of malnutrition in brain-injured patients may be underestimated. The different etiologies of malnutrition should be sought, individual serial assessments made, and appropriate therapy administered. There is a need for more research on the effect of improved nutritional status on medical complications and functional outcome during rehabilitation. Future research should look at all of the variables that may have an effect on nutritional status and functional outcome, use sensitive outcome measures, and include enough subjects to look at co-variances.