Nutritional support still valuable in well-nourished patients

Even among patients who are already well-nourished, nutritional support provides clinical benefit, such as lower morbidity and fewer infectious complications reports a new meta-analysis.

Drawing from the databases of PubMed, the Cochrane Library, and Web of Science, researchers retrieved 10 controlled trials (nine randomized and one not) eligible for quantitative analysis. The pooled study population included 1,400 well-nourished patients undergoing surgery for gastrointestinal or head-and-neck cancer.

Morbidity was examined in all 10 studies. The pooled analysis showed that nutritional intervention decreased the likelihood of morbidity, but not to a significant degree. In sensitivity analysis, however, where the most highly weighted study was eliminated, researchers found a significant benefit of the intervention on morbidity (odds ratio [OR], 0.75, 95 percent confidence interval [CI], 0.57–0.99).

Similarly, infectious complications were fewer (nine studies; OR, 0.74, 95 percent CI, 0.57–0.96) in patients who had taken nutritional support.

In contrast, the intervention had no such effects on mortality (eight studies: OR, 1.25, 95 percent CI, 0.33–4.70) and length of hospital stay (six studies; mean difference, –0.67; 95 percent CI, –1.89 to –0.51).

The principal findings were robust to subgroup and sensitivity analyses, and the Grades of Recommendation Assessment Development and Evaluation found that each outcome was of moderate-to-high quality.

“Few studies have investigated the effects of nutritional supplementation on patients who are well nourished. Therefore, additional randomized controlled trials are warranted to determine the effects of nutritional support on well-nourished patients,” researchers said.