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Apoyo nutricional individualizado en pacientes hospitalizados con riesgo nutricional: ensayo clínico aleatorizado
Philipp Schuetz1, Rebecca Fehr2, Valerie Baechli2
1Medical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland; Medical Faculty of the University of Basel, Basel, Switzerland.
Lancet (London, England)
|April 30, 2019
Resumen
El apoyo nutricional individualizado para pacientes hospitalizados en riesgo mejoró significativamente los resultados clínicos, incluida la supervivencia, en comparación con las dietas hospitalarias estándar. Esto pone de relieve la importancia del cribado nutricional y la intervención para una mejor recuperación del paciente.
Área de la Ciencia:
- Nutrición clínica
- Medicina de los hospitales
- Resultados en pacientes
Sus antecedentes:
- Las directrices actuales recomiendan apoyo nutricional para pacientes hospitalizados en riesgo.
- La evidencia que respalda estas recomendaciones es limitada, con preocupaciones sobre los posibles impactos negativos de la terapia nutricional durante la enfermedad aguda.
Objetivo del estudio:
- Probar si el apoyo nutricional individualizado guiado por el protocolo mejora los resultados clínicos en pacientes hospitalizados con riesgo nutricional.
Principales métodos:
- El estudio Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) fue un estudio multicéntrico y aleatorizado en el que se evaluaron los efectos de la nutrición temprana en la fragilidad, los resultados funcionales y la recuperación de los pacientes hospitalizados con desnutrición.
- 2088 pacientes médicos con riesgo nutricional fueron asignados a recibir apoyo nutricional individualizado o comida hospitalaria estándar.
- El criterio de valoración primario fue un compuesto de resultados clínicos adversos a los 30 días.
Principales resultados:
- El 23% de los pacientes que recibieron apoyo nutricional individualizado experimentaron un resultado adverso frente al 27% en el grupo de control (OR 0,79, p=0,023).
- La mortalidad fue menor en el grupo de intervención (7% vs 10%, OR 0,65, p=0,011).
- No se observaron diferencias significativas en los efectos secundarios entre los grupos.
Conclusiones:
- El apoyo nutricional individualizado en pacientes hospitalizados en riesgo mejora los resultados clínicos, incluida la supervivencia.
- El cribado nutricional sistemático y la intervención oportuna son cruciales para los pacientes hospitalizados con riesgo nutricional.
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