Relationship between Nutritional Risk, Clinical and Demographic Characteristics, and Pressure Ulcers in Patients with Severe Acquired Brain Injuries Attending a Rehabilitative Program.

Chiara Francesca Gheri, Luca Scalfi, Barbara Biffi, Silvia Pancani, Sara Madiai, Olivia Di Vincenzo, Michele Ghaderi, Rebecca Celoni, Mara Dalladonna, Francesca Draghi, Daniela Maccanti, Claudio Macchi, Anna Maria Romoli, Francesca Cecchi, Bahia Hakiki, Maria Luisa Eliana Luisi

Journal: Nutrients 2023;15(15):3336

PMID: 37571274

Abstract

Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.

Address: IRCCS Fondazione Don Carlo Gnocchi ONLUS Firenze, 50143 Florence, Italy.; Human Nutrition and Dietetics, Department of Public Health, Federico II University, 80131 Naples, Italy.; Santa Maria del Pozzo Private Hospital, Somma Vesuviana, 80049 Naples, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 50134 Florence, Italy.
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