OBJECTIVE: To determine whether nutritional supplementation following hospital discharge in patients who undergo gastrointestinal (GI) surgery is beneficial in specific outcome measures. METHODS: A systematic review was conducted of randomized controlled trials comparing nutritional supplements vs a "standard care" regimen given to patients following discharge from hospital after GI surgery. Outcome measures were weight change, quality of life, clinical complications, fatigue, and hand grip strength. RESULTS: Four studies were identified. Postdischarge oral nutritional supplements were found to be safe and increased energy intake, protein intake, and weight in patients after discharge from hospital. The greatest gains in weight were seen in malnourished patients. Little evidence was found that nutritional supplements reduce morbidity or improve quality of life, fatigue, or hand-grip strength. Only one study was methodologically adequate, and none were powered to detect differences in clinical complications. CONCLUSIONS: In patients who undergo GI surgery and receive nutritional supplements after discharge from hospital, little evidence of clinical benefit was found, principally through lack of robust data. All the studies were under-powered or not specifically designed to show benefit during this period. It is recommended that nutritional supplements be offered to malnourished patients or those at high risk of poor dietary intake at discharge from hospital.
OBJECTIVE: To determine whether nutritional supplementation following hospital discharge in patients who undergo gastrointestinal (GI) surgery is beneficial in specific outcome measures. METHODS: A systematic review was conducted of randomized controlled trials comparing nutritional supplements vs a "standard care" regimen given to patients following discharge from hospital after GI surgery. Outcome measures were weight change, quality of life, clinical complications, fatigue, and hand grip strength. RESULTS: Four studies were identified. Postdischarge oral nutritional supplements were found to be safe and increased energy intake, protein intake, and weight in patients after discharge from hospital. The greatest gains in weight were seen in malnourished patients. Little evidence was found that nutritional supplements reduce morbidity or improve quality of life, fatigue, or hand-grip strength. Only one study was methodologically adequate, and none were powered to detect differences in clinical complications. CONCLUSIONS: In patients who undergo GI surgery and receive nutritional supplements after discharge from hospital, little evidence of clinical benefit was found, principally through lack of robust data. All the studies were under-powered or not specifically designed to show benefit during this period. It is recommended that nutritional supplements be offered to malnourished patients or those at high risk of poor dietary intake at discharge from hospital.
Authors: Kristoffer Lassen; Marielle M E Coolsen; Karem Slim; Francesco Carli; José E de Aguilar-Nascimento; Markus Schäfer; Rowan W Parks; Kenneth C H Fearon; Dileep N Lobo; Nicolas Demartines; Marco Braga; Olle Ljungqvist; Cornelis H C Dejong Journal: World J Surg Date: 2013-02 Impact factor: 3.352