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Suplementación nutricional oral de rutina para pacientes con accidente cerebrovascular en el hospital (FOOD): un

M S Dennis¹, S C Lewis, C Warlow

¹Department of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, UK. martin.dennis@ed.ac.uk

Lancet (London, England)

|March 1, 2005

Resumen

Los suplementos nutricionales orales de rutina no mejoraron significativamente los resultados para la mayoría de los pacientes hospitalizados con accidente cerebrovascular. El estudio no encontró un beneficio claro, lo que sugiere que la suplementación no debería ser una práctica estándar después del accidente cerebrovascular.

Área de la Ciencia:

Nutrición clínica La nutrición clínica es la nutrición clínica.
Neurología Neurología.
Salud Pública La salud pública.

Sus antecedentes:

La desnutrición es prevalente en pacientes hospitalizados con accidente cerebrovascular, a menudo empeorando durante su estadía y vinculada a resultados adversos.
El estudio aborda la necesidad de determinar si las intervenciones nutricionales pueden mitigar estos riesgos.

Objetivo del estudio:

Investigar la eficacia de los suplementos nutricionales orales de rutina en la mejora de los resultados para los pacientes hospitalizados después de un accidente cerebrovascular.
Evaluar el impacto de la suplementación nutricional en la mortalidad y el estado funcional.

Principales métodos:

Una serie de tres ensayos controlados aleatorios pragmáticos, multicéntricos y multicéntricos (ensayos FOOD) en los que participaron 4023 pacientes con accidente cerebrovascular que podían tragar.
Los pacientes fueron asignados al azar a una dieta hospitalaria normal o a una dieta hospitalaria normal complementada con productos nutricionales orales hasta el alta.
El resultado primario fue la muerte o un mal resultado funcional (escala de Rankin modificada 3-5) a los 6 meses, evaluado a través del análisis de intención de tratar.

Principales resultados:

Solo el 8% de los pacientes inscritos fueron identificados como desnutridos al inicio.
Las dietas suplementadas mostraron una reducción absoluta no significativa en el riesgo de mortalidad del 0,7% y un aumento no significativo en el riesgo de muerte o mal resultado del 0,7% a los 6 meses.
Los resultados fueron compatibles con un beneficio o daño absoluto del 1-2% de los suplementos orales.

Conclusiones:

El estudio no confirmó el beneficio esperado de los suplementos nutricionales orales de rutina para pacientes con accidente cerebrovascular, particularmente aquellos que están bien nutridos.
Los hallazgos no apoyan la implementación de la suplementación oral de rutina como una política de atención estándar para pacientes con accidente cerebrovascular.
Es posible que se necesite más investigación para identificar subgrupos específicos de pacientes que podrían beneficiarse del apoyo nutricional.

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