Subacute prognosis of oral nutrition (SPOON): Development of a multivariable prognostic model for complete oral intake in tube-fed subjects with acquired brain injury.
Enteral feeding is very common following an acquired brain injury. However, no prognostic models for oral food intake have been developed for subacute rehabilitation. The aim of this study was to develop a prognostic model and online tool, coined "subacute prognosis of oral nutrition" (SPOON), for c...
| Published in: | Clinical Nutrition Vol. 42; no. 9; pp. 1770 - 1778 |
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| Main Authors: | , |
| Format: | research Journal Article |
| Published: |
Elsevier B.V.
Sep2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=170087225&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 170087225 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02615614 8IC jtl: Clinical Nutrition issn: 02615614 maglogo: N pubinfo: dt: Sep2023 vid: 42 iid: 9 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 170087225 170087225 170087225 10.1016/j.clnu.2023.07.007 170087225 ppf: 1770 ppct: 8 formats: tig: atl: Subacute prognosis of oral nutrition (SPOON): Development of a multivariable prognostic model for complete oral intake in tube-fed subjects with acquired brain injury. aug: au: Fabricius, Jesper Pedersen, Asger Roer affil: Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Voldbyvej 15, 8450, Hammel, Denmark sug: subj: Enteral Nutrition Brain Injuries Prognosis Food Intake Subacute Care Brain Injuries Rehabilitation Instrument Construction Human Odds Ratio Confidence Intervals Age Factors Tracheostomy Tube Young Adult Adult Feedback Adult: 19-44 years ab: Enteral feeding is very common following an acquired brain injury. However, no prognostic models for oral food intake have been developed for subacute rehabilitation. The aim of this study was to develop a prognostic model and online tool, coined "subacute prognosis of oral nutrition" (SPOON), for complete oral intake in tube-fed subjects with acquired brain injury. The model was developed using routinely gathered clinical data from a cohort of 1233 adult patients who were tube-fed at admission for sub-acute inpatient rehabilitation. Candidate predictors were included based on scientific evidence and their availability in the medical records within the first days following admission. The outcome was time until achieving complete oral food intake without any tube-feeding supplements. Time until complete oral intake was analyzed by discrete time-to-event analysis with logit-link and presented as daily odds ratios (OR) with 95% confidence intervals (CI). The following predictors of complete oral intake were included in the model: age, diagnosis, cuffed tracheostomy tube, days from injury to admission for rehabilitation, and the Early Functional Abilities (EFA) sum score. Multiple adjusted analyses were performed stratified by cuffed tracheostomy tube status. Some of the strongest predictors of complete oral intake were age 18–40 years, OR 1.99 (95%CI: 1.53; 2.59); 0–2 weeks since injury, OR 3.75 (95%CI: 2.72; 5.16); and EFA 61–100 (slight/no disturbance in function), OR 5.81 (95%CI: 4.47; 7.55). The online prognostic tool SPOON was evaluated in a usability study. Based on feedback from clinicians, the tool was further refined to enable extraction of data for prediction directly from medical records. The objective of SPOON is to complement the planning of rehabilitation initiatives and inform discussions to determine if a percutaneous endoscopic gastrostomy (PEG) tube should be inserted. SPOON is being implemented locally, but external validation based on appropriate data modeling is warranted before further clinical implementation. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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