DISASTER MEDICINE No. 2•2021
Peculiarities of Trophological Status in Victims of Emergencies with Long Consciousness Impairment Due to Craniocerebral Injury
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Nikiforov M.V.1, Korolev A.A.1
1 Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, St. Petersburg, Russian Federation
Abstract. The aim of the study was to investigate peculiarities of trophological status, to identify prevalence, severity and types of trophological insufficiency and to analyze the effect of infectious complications on the severity of protein-energy malnutrition in victims of emergency situations with long-term impairment of consciousness due to traumatic brain injury.
Materials and research methods. The study involved 126 victims of various age groups, who underwent primary screening using NRS-2002 scale, indicators of trophological status and the effect of infectious complications on the severity of protein-energy malnutrition were assessed.
Research results and their analysis. Screening showed a high risk of malnutrition in all patients. Indicators of trophological status were less than the reference values. In all age groups, both men and women, moderate protein-energy malnutrition prevailed (82.5%). For young patients, marasmus (64.6%) and marasmic kwashiorkor (34.3%) were most typical. The trophological status of the victims – regardless of the severity and in more than half of the cases – was represented by marasmus and, less often, by kwashiorkor. Patients with infectious complications had a high risk of moderate and severe protein-energy malnutrition development, p <0.001.
Key words: emergency situations, long-term impairment of consciousness, nutritional support, PEM, protein-energy malnutrition, traumatic brain injury, trophological status
For citation: Nikiforov M.V., Korolev A.A. Peculiarities of Trophological Status in Victims of Emergencies with Long Consciousness Impairment Due to Craniocerebral Injury. Meditsina katastrof = Disaster Medicine. 2021;2:50-54 (In Russ.). https://doi.org/10.33266/2070-1004-2021-2-50-54
- Ovsyannikov D.M., Chekhonatskiy A.A., Kolesov V.N., et al. Social and Epidemiological Aspects of Craniocerebral Trauma (Review). Saratovskiy Nauchno-Meditsinskiy Zhurnal = Saratov Journal of Medical Scientific Research. 2012;8;3:777–785. (In Russ.).
- Korolev V.M. Epidemiological and Clinical Aspects of the Combinedl Trauma. Dal’nevostochnyy Meditsinskiy Zhurnal = Far Eastern Medical Journal. 2011;3:124–128. (In Russ.)
- Jessica N. Holland, Adam T. Schmidt. Static and Dynamic Factors Promoting Resilience following Traumatic Brain Injury: a Brief Review. Neural Plasticity. 2015;2015:1–8. DOI:10.1155/2015/902802.
- Kofer M., Schiefecker A.J., Beer R., et al. Enteral Nutrition Increases Interstitial Brain Glucose Levels in Poor-Grade Subarachnoid Hemorrhage Patients. Journal of Cerebral Blood Flow & Metabolism. 2017;38;3:518–527. DOI: 10.1177/0271678X17700434.
- Luft V.M., Afonchikov V.S., Dmitriev A.V., et al. Rukovodstvo po Klinicheskomu Pitaniyu: Monografiya = Clinical Nutrition Guide: Monograph. St. Petersburg Publ., 2016, 492 p. (In Russ.).
- Vainshenker Yu.I., Ivchenko I.M., Tsinzerling V.A., et al. Infectious Factors of Brain Damage in Long-Term Unconscious Conditions. Annaly Klinicheskoy i Eksperimental’noy Nevrologii = Annals of Clinical and Experimental Neurology. 2014;8;3:21–29 (In Russ.).
- Kalmar K., Giacino J.T. The JFK Coma Recovery Scale-Revised. Neuropsychological Rehabilitation. 2005;15;3-4:454–460. DOI: 10.1080/09602010443000425.
- Mochalova E.G., Legostaeva L.A., Zimin A.A., et al. The Russian Version of Coma Recovery Scale-revised – a Standardized Method for Assessment of Patients with Disorders of Consciousness. Zhurnal Nevrologii i Psikhiatrii im. S.S.Korsakova = S.S.Korsakov Journal of Neurology and Psychiatry. 2018;118;3-2:25–31 (In Russ.).
- Kondrup J., Rasmussen H.H., Hamberg O., et al. Nutritional Risk Screening (NRS 2002): a New Method Based on an Analysis of Controlled Clinical Trials. Clin Nutr. 2003;22;3:321–336. DOI: 10.1016/s0261-5614(02)00214-5.
- Loser Chr., Aschl G., Hebuterne X., et al. ESPEN Guidelines on Artificial Enteral Nutrition – Percutaneous Endoscopic Gastrostomy (PEG). Consensus Statement. Clinical Nutrition. 2005;24:848–861. DOI: 10.1016/j.clnu.2005.06.013.
The material was received 09.03.21; the article after peer review procedure 30.03.21; the Editorial Board accepted the article for publication 15.06.21