03 June 2022 : Clinical Research
Early Enteral Nutrition Can Reduce Incidence of Postoperative Hydrocephalus in Patients with Severe Hypertensive Intracerebral Hemorrhage
Zhi Cai1BCE, Kai Zhao1AEG, Yu Li1BC, Xueyan Wan1B, Chunlin Li1B, Hongquan Niu1DF, Kai Shu1DF, Ting Lei1A*DOI: 10.12659/MSM.935850
Med Sci Monit 2022; 28:e935850
Table 2 The comparative analysis of patients with hydrocephalus.
| Variables | Acute hydrocephalus (27 vs 119) | P value | Chronic hydrocephalus (20 vs 99) | P value | ||
|---|---|---|---|---|---|---|
| Yes (n=27) | No (n=119) | Yes (n=20) | No (n=99) | |||
| Age, years (SD) | 51.3 (11.3) | 51.7 (11.5) | 0.866 | 50.0 (9.4) | 52.1 (11.9) | 0.449 |
| Gender, male (%) | 15 (55.6) | 72 (60.5) | 0.636 | 12 (60.0) | 60 (60.6) | 0.960 |
| Nutritional status at admission | ||||||
| BMI, kg/m (SD) | 24.7 (3.9) | 24.0 (3.5) | 0.376 | 23.4 (4.0) | 24.1 (3.3) | 0.374 |
| Mid-arm muscle circumference, cm (SD) | 30.8 (4.1) | 30.0 (4.6) | 0.411 | 29.3 (4.6) | 30.4 (4.5) | 0.462 |
| Albumin, g/L (M (P, P)) | 40.7 (35.9, 46.8) | 42.8 (39.6, 47.9) | 0.153 | 40.1 (37.4, 45.3) | 43.3 (40.1, 48.2) | 0.110 |
| SGA (%) | 0.834 | 0.688 | ||||
| Well-nourished | 2 (7.4) | 7 (5.9) | 2 (10.0) | 5 (5.1) | ||
| Moderately malnourished6 | 17 (63.0) | 82 (68.9) | 13 (65.0) | 69 (69.7) | ||
| Severely malnourished | 8 (29.6) | 30 (25.2) | 5 (25.0) | 25 (25.2) | ||
| Volume of hematoma, ml (SD) | 45.0 (25.1) | 50.5 (23.1) | 0.272 | 54.3 (27.0) | 49.8 (22.1) | 0.425 |
| SAH (%) | 8 (29.6) | 17 (14.3) | 0.056 | 6 (30.0) | 11 (11.1) | * |
| IVH (%) | 22 (81.5) | 62 (52.1) | * | 17 (85.0) | 45 (45.5) | * |
| Preoperative GCS (M (P, P)) | 5.9 (5, 8) | 6.2 (5, 8) | 0.417 | 5.5 (4, 7) | 6.5 (5, 8) | * |
| Surgical treatment (%) | 0.121 | 0.347 | ||||
| Hematoma removal | 15 (55.6) | 88 (73.9) | 16 (80.0) | 72 (72.7) | ||
| DC | 6 (22.2) | 22 (18.5) | 2 (10.0) | 20 (20.2) | ||
| EVD | 13 (48.1) | 32 (36.9) | 3 (15.0) | 29 (29.2) | ||
| EN application (%) | 0.125 | * | ||||
| Early EN | 6 (11.8) | 45 (88.2) | 3 (6.7) | 42 (93.3) | ||
| Delayed EN | 21 (22.1) | 74 (77.9) | 17 (23.0) | 57 (77.0) | ||
| Postoperative GCS (M (P, P)) | 9.7 (8, 13) | 10.5 (7, 14) | 0.411 | 9.5 (6.3, 12.8) | 10.8 (7, 14) | 0.157 |
| mRS (SD) | 4.2 (0.4) | 4.2 (0.4) | 0.510 | 4.1 (0.3) | 4.2 (0.4) | 0.376 |
| Nutritional status at two weeks postoperatively | ||||||
| BMI, kg/m (SD) | 23.4 (3.2) | 23.0 (2.9) | 0.485 | 22.6 (3.3) | 23.0 (2.8) | 0.517 |
| Mid-arm muscle circumference, cm (SD) | 29.4 (3.8) | 28.4 (3.9) | 0.252 | 28.3 (4.3) | 28.4 (3.9) | 0.862 |
| Albumin, g/L (SD) | 32.8 (4.0) | 33.8 (5.1) | 0.338 | 34.8 (6.1) | 33.6 (4.9) | 0.342 |
| SGA (%) | 0.180 | 0.634 | ||||
| Well-nourished | 5 (18.5) | 9 (7.6) | 2 (10.0) | 7 (7.1) | ||
| Moderately malnourished | 18 (66.7) | 83 (69.7) | 15 (75.0) | 68 (68.7) | ||
| Severely malnourished | 4 (14.8) | 27 (22.7) | 3 (15.0) | 24 (24.2) | ||
| Laboratory results | ||||||
| White blood cells, 10 (SD) | 15.7 (6.4) | 14.0 (4.7) | 0.137 | 16.5 (4.3) | 13.5 (4.6) | * |
| Neutrophil, 10 (M (P, P)) | 13.3 (8.7, 15.2) | 11.7 (8.4, 14.9) | 0.283 | 14.1 (11.3, 16.9) | 11.2 (8.1, 14.6) | * |
| Lymphocyte, 10 (M (P, P)) | 1.2 (0.9, 1.4) | 1.2 (0.9, 1.4) | 0.605 | 1.1 (0.9, 1.3) | 1.2 (0.9, 1.4) | 0.477 |
| Monocyte, 10 (SD) | 1.2 (0.7) | 1.2 (0.4) | 0.621 | 1.3 (0.5) | 1.1 (0.4) | 0.212 |
| Platelet, 10 (M (P, P)) | 277.3 (185, 377) | 262.7 (166, 324) | 0.484 | 256.4 (160, 338) | 263.9 (166, 322) | 0.909 |
| NLR, (M (P, P)) | 14.0 (7.3, 17.2) | 10.6 (7.1, 13.5) | 0.282 | 13.1 (9.9, 14.3) | 10.1 (6.4, 12.4) | * |
| dNLR, (M (P, P)) | 2.0 (1.7, 2.2) | 2.0 (1.8, 2.2) | 0.832 | 2.1 (1.9, 2.2) | 2.0 (1.7, 2.1) | 0.614 |
| MLR, (M (P, P)) | 1.0 (0.7, 1.2) | 1.0 (0.8, 1.2) | 0.832 | 1.1 (0.9, 1.2) | 1.0 (0.7, 1.1) | 0.614 |
| PLR, (M (P, P)) | 262.7 (198.1, 341.7) | 231.0 (164.3, 275.2) | 0.083 | 242.4 (140.7, 331.0) | 228.7 (166.7, 275.2) | 0.876 |
| CRP, mg/L (M (P, P)) | 50.6 (21.1, 66.0) | 39.5 (10.1, 60.7) | 0.063 | 58.9 (26.8, 80.3) | 35.8 (8.4, 50.5) | * |
| LDH, U/L (M (P, P)) | 309.5 (223, 362) | 286.6 (213, 354) | 0.662 | 316.9 (256, 362) | 278.5 (202, 339) | * |
| BMI – body mass index; CRP – C-reactive protein; DC – decompression craniectomy; dNLR – derived NLR; EN – enteral nutrition; EVD – extraventricular drainage; GCS – Glasgow coma scale; IVH – intraventricular hemorrhage; LDH – lactate dehydrogenase; MLR – monocyte-to-lymphocyte ratio; mRS – Modified Rankin Scale; NLR – neutrophil-to-lymphocyte ratio; PLR – platelet-to-lymphocyte ratio; SAH – subarachnoid hemorrhage; SD – standard deviation; SGA – subjective global assessment. * | ||||||