Nutritional status in patients with Disorders of Consciousness

Abstract

Event Abstract Back to Event Nutritional status in patients with Disorders of Consciousness Camilla Ippoliti1*, Marjorie Fadeur2, Christian Malherbe3, Olivia Gosseries1, Anne-Marie Verbrugge3, Jenny DeFilnes2, Steven Laureys1, Nicolas Paquot2 and Aurore Thibaut1 1 Coma Science Group, University of Liège, Belgium 2 Service de Diabétologie, Nutrition et Maladies Métaboliques, CHU Liège, Belgium 3 Service de Diététique, CHU Liège, Belgium Short summary To date, scientific literature about the nutritional status of patients with Disorder of Consciousness (DOC) is poor and under-investigated even if a balanced and adequate nutrition is essential for the rehabilitation process and patient’s quality of life. According to our results, the majority of patients are well nourished (88%), but there is still an important minority (12%) of them that is undernourished (1%) or at risk to be undernourished (11%). Therefore, a better understanding of the mechanisms and variables that can impact on nutritional processes is required and future studies should deepen the possible relation existing between nutritional variables, clinical variables and levels of consciousness. Introduction and goals of the study To date, scientific literature about the nutritional status of patients with Disorder of Consciousness (DOC) is poor and under-investigated. Therefore, the aim of this study is to investigate if there is a relation between nutritional variables, consciousness and other clinical variables. Materials and Method We have collected and analyzed clinical (diagnosis) and nutritional (caloric and protein intake, BMI, risk of being undernourished, type of alimentation) data from 86 DOC patients that were in an unresponsive wakefulness syndrome (UWS)2, in a minimally conscious state (MCS)3,4 or patients who emerged from MCS (EMCS) 3,4. We performed t-tests for group comparisons and two sample tests for proportions. Results Out of 86 patients, 21 were UWS (mean age 45±15; time since injury 2±3), 49 were MCS (mean age 43±17; time since injury 3±4), and 16 patients were EMCS (mean age 42±16; time since injury 4±5). There was no significative difference in the BMI and in the daily caloric and protein intake between groups. One patient (1% of the total sample - EMCS) was found undernourished, nine patients (11% of the total sample) were at risk to be undernourished (5 UWS patients and 4 MCS patients) and the remaining 76 patients (88% of the total sample) were not undernourished (16 UWS, 45 MCS, 15 EMCS). We identified a trend for UWS patients to be more “at risk to be undernourished” compared to MCS patient (p=0.066) (Figure 1). Out of 86 patients, 9 (11%) were fed orally: 2 patients were UWS (9.25%), 3 MCS (6.12%) and 4 EMCS (25.00%). The proportion of EMCS patients fed orally was significantly higher compared to MCS patients (p=0.03) (Image 1). Conclusion According to our results, a large majority of patients are well nourished (88%). However, the chances to be undernourished tend to be higher in UWS patients (5/21 patients). The recovery of consciousness also seems to increase the possibility to be orally fed since 25% of EMCS patients are fed orally. Therefore, further studies evaluating DOC patients’ nutritional profile should be conducted in order to better understand the variables that could potentially explains the reasons of undernourishment, such as the etiology, time since injury and basal energy expenditure. Figure 1 Image 1 References