Association between enteral nutrition support and neurological outcome in patients with acute intracranial haemorrhage: A retrospective cohort study

Association between the amount of enteral nutrition (EN) caloric intake and Glasgow coma scale scores at discharge (GCS(dis)) in intracranial haemorrhage (ICH) was retrospectively investigated in 230 patients in a single center from 2015 and 2017. GCS(dis) was used as a dichotomous outcome (≤8 or >8: 56/230 vs. 174/230) and its association with the amount of EN caloric intake within 48 hours was analysed in four logistic models. Model 1 used EN as a continuous variable and showed association with favourable GCS(dis) (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01–1.08). Models 2 and 3 categorized EN into two (≤25 and >25 kcal/kg/48 hrs) and three caloric intake levels (≤10, 10~25, and >25 kcal/kg/48 hrs) respectively, and compared them with the lowest level; highest EN level associated with favourable GCS(dis) in both model 2 (OR, 2.77; 95%CI, 1.25–6.13) and 3 (OR, 4.68; 95%CI, 1.61–13.61). Model 4 transformed EN into four quartiles (Q1-Q4). Compared to Q1, OR increased stepwise from Q2 (OR 1.80, 95%CI 0.59–5.44) to Q4 (OR 4.71, 95%CI 1.49–14.80). Propensity score matching analysis of 69 matched pairs demonstrated consistent findings. In the early stage of ICH, increased EN was associated with favourable GCS(dis).