Research Reports - Changes in weight after traumatic brain injury in adult patients

Clin Nutr. 2013 Jun 10. pii: S0261-5614(13)00175-1

Crenn P, Hamchaoui S, Bourget-Massari A, Hanachi M, Melchior JC, Azouvi P

BACKGROUND & AIMS: Although changes in weight have been reported after traumatic
brain injury (TBI), their frequency and underlying factors are little known. Our
aim was to determine the prevalence of weight changes and the associated factors
during the recovery phase after TBI.
METHODS: Longitudinal follow-up of adults with TBI. Multivariate analysis was
carried out on weight change, demographic data, dysexecutive syndrome, eating
behavior, physical activity, therapeutic classes and metabolic complications.
RESULTS: 107 patients (81 males/26 females), age 36 ± 13 yrs, baseline BMI
23.3 ± 3.9, followed for 38 (8-66) months, were included. In intensive care,
patients lost a mean 11 ± 6 kg. End of follow-up, mean BMI was not different to
pre-TBI BMI, but patients could be categorized in 3 groups: stable (30%), loss
(28%, -8 ± 7 kg) and gain (42%, +9 ± 6 kg). Sex, age, severity of TBI, intensive
care weight loss, physical activity, therapeutic classes and the occurrence of
metabolic syndrome did not differ between the groups. Factors related to weight
gain were hyperphagia, OR 4.5 (IC95%, 1.6-12.1) and presence of a dysexecutive
syndrome, OR 2.5 (IC95%, 1.03-6.3). Factors related to weight loss were
hypophagia, OR 4.1 (IC95%, 1.5-10.9) and higher pre-TBI BMI, OR 4.9 (IC95%,
1.7-14.0).
CONCLUSIONS: Over a median period of 38 months, 42% of TBI patients gained and
28% lost weight. Factors associated with these changes were the presence of a
behavioral dysexecutive syndrome for weight gain, oral food intake and initial
BMI, which were inversely associated with weight at end of follow-up. These
findings highlight the importance of evaluating the time course of weight changes
and providing specific nutritional care.

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