What is the nutritional status of patients with prolonged disorders of consciousness? A retrospective cross-sectional study

ABSTRACT

Background

Nutritional status of patients with disorders of consciousness (DoC) is poorly studied.

Objectives

To evaluate the relationship between nutritional status (body mass index, daily calories intake) and clinical variables (level of consciousness, time since injury, diagnosis, etiology and spastic muscle overactivity; SMO,) in patients with prolonged DoCor emerging. Our main hypotheses are i) patients with lower level of consciousness (UWS) have worse nutritional status compared to patients in minimally conscious state (MCS) and ii) SMO could influence nutritional status.

Methods and results

Among the 80 patients included in the study (19 UWS, 47 MCS, 14 emerging MCS; 43 ± 15 yo; 3 ± 4 years post-injury, 35 traumatic etiology, 34 females), 9% were at risk to be undernourished, with no differences between UWS and MCS. Patients without SMO had a higher BMI compared to patients with severe SMO. Compared to the recommended daily calories intake, patients with the highest BMI received less calories and patients with the lowest BMI received more calories. We observed a negative correlation between SMO (in lower limbs) and BMI.

Conclusion

Our study shows that most patients are well nourished, independently from the level of consciousness. SMO may require additional calories in patients’ daily needs; however, longitudinal studies are needed to explore the causal relationship between these variables.

KEYWORDS:

• UWS
• MCS
• nutrition
• spastic muscle overactivity
• BMI

Acknowledgments

The study was supported by the University and University Hospital of Liege, the Belgian National Funds for Scientific Research (FRS-FNRS), the European Union’s Horizon 2020 Framework Program for Research and Innovation under the Specific Grant Agreement No. 945539 (Human Brain Project SGA3), the European Space Agency (ESA) and the Belgian Federal Science Policy Office (BELSPO) in the framework of the PRODEX Program, ‘Fondazione Europea di RicercaBiomedica,’ the BIAL Foundation, the Mind Science Foundation and the European Commission, the fund Generet, the Mind Care International Foundation, the King Baudouin Foundation, and DOCMA project [EU-H2020-MSCA-RISE-778234]. We are highly grateful to the members of the Liège Coma Science Group for their assistance in clinical evaluations. We also thank the patients and their families. OG and AT are research associates, and SL is research director at F.R.S-FNRS.

Disclosure statement

The authors report there are no competing interests to declare.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Authors’ contributions

MF, SL, NP, CI, AT planned and designed the study, MF and CM collected the data. CI and AT analyzed the data. CI, MF, AT and CM interpreted the results. CI wrote the paper under AT supervision. All authors critically revised the paper and gave their approval to the final version of the manuscript.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.