Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Impact of Early Enteral Nutrition on In-Hospital Mortality in Patients with Hypertensive Intracerebral Hemorrhage

  • Lee, Jeong-Shik (Department of Neurosurgery, National Medical Center) ;
  • Jwa, Cheol-Su (Department of Neurosurgery, National Medical Center) ;
  • Yi, Hyeong-Joong (Department of Neurosurgery, Hanyang University Medical Center) ;
  • Chun, Hyoung-Joon (Department of Neurosurgery, Hanyang University Medical Center)
  • Received : 2010.04.09
  • Accepted : 2010.08.03
  • Published : 2010.08.28
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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 ($\geq$ 48 hours, n = 34). Body weight, total intake and output, serum albumin, Creactive 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.

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References

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