医学
随机对照试验
荟萃分析
内科学
入射(几何)
外科
系统回顾
物理疗法
梅德林
物理
法学
光学
政治学
作者
A.L. Cawood,Sorrel Burden,Trevor Smith,Rebecca J. Stratton
标识
DOI:10.1016/j.arr.2023.101953
摘要
The impact of oral nutritional supplements (ONS) on patients with complications (disease related morbidity) requires further exploration. This systematic review included 44 randomised controlled trials (RCT) (29 RCT surgical, 15 RCT medical patients) examining the effect of ONS in community settings on the incidence of complications (n5716, mean age 67 years, range 35–87). ONS (mean intake 588 kcal/day, range 125–1750; protein 22 g/day, range 0–54; mean energy from protein 22 %, range 0–54) were prescribed for a mean 74 days, range 5–365. Most RCT (77 %) reported fewer complications in the ONS group versus control. Meta-analysis (39 RCT) showed ONS consumption reduced complications including infections, pressure ulcers, wound and fracture healing (OR 0.68, 95 % CI 0.59,0.79; p<0.001). Results showed reductions when ONS were used in hospital and community settings (OR 0.72, 95 % CI 0.59,0.87; p = 0.001) or just in the community (OR 0.65, 95 % CI 0.52, 0.80; p<0.001). Reductions in complications were only seen with high ONS adherence ≥ 80 % (OR 0.63, 95 % CI 0.48,0.83; p = 0.001) and ready-to-drink ONS (OR 0.69, 95 % CI 0.60,0.81; p<0.001). This systematic review and meta-analysis show community-based use of ONS in addition to the diet substantially reduces the incidence of complications. The diversity of ONS, patient populations and complication outcomes within the trials included in this review mean further research is warranted.
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