ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurorehabilitation
Impact of Early Enteral Nutrition Combined with Bedside Rehabilitation on Functional Outcomes and Length of Stay in Patients with Severe Subarachnoid Hemorrhage: A Retrospective Cohort Study
Nanjing No. 1 Hospital, Nanjing, China
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Abstract
Objective: Early enteral nutrition (EEN) and early rehabilitation have individually demonstrated benefits in neurocritical care. However, the synergistic effects of combining these interventions in severe subarachnoid hemorrhage (SAH) remain unexplored. This study aimed to evaluate the impact of a combined early enteral nutrition and bedside rehabilitation protocol on functional outcomes and length of stay in patients with severe SAH. Methods: This retrospective cohort study included 102 patients with severe SAH (Hunt-Hess grade III-V) admitted to the neurosurgical intensive care unit between August 2023 and August 2025. Patients were divided into a combined intervention group (n = 53), receiving EEN within 48 hours and comprehensive bedside rehabilitation within 72 hours, and a standard care group (n = 49). The primary outcome was favorable functional status (modified Rankin Scale [mRS] 0-2) at 6 months. Secondary outcomes included mRS at discharge and 90 days, length of stay, complications, and mortality. Results: Favorable outcome at 6 months was significantly higher in the combined intervention group compared to standard care (64.2% vs 30.6%, P=0.001). Multivariable logistic regression identified combined intervention as an independently associated with favorable outcome (adjusted OR: 3.42, 95% CI: 1.38-8.47, P=0.008). The intervention group demonstrated significantly shorter ICU stay (13.5 vs 19.8 days, P=0.001) and hospital stay (22.4 vs 26.9 days, P=0.004). Rates of delayed cerebral ischemia (13.2% vs 42.9%, P=0.002), cerebral vasospasm (15.1% vs 36.7%, P=0.023), and in-hospital mortality (0% vs 14.3%, P=0.005) were significantly lower in the intervention group. Conclusions: Combined early enteral nutrition and bedside rehabilitation was associated with improved functional outcomes and reduced length of stay in severe SAH patients. This multimodal support further investigation of this multimodal approach in prospective trials.
Summary
Keywords
bedside rehabilitation, Early enteral nutrition, functional outcome, Modified Rankin scale, neurocritical care, Subarachnoid Hemorrhage
Received
16 December 2025
Accepted
02 February 2026
Copyright
© 2026 Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Chunhong Ma
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