栄養上のリスクのある入院患者の個別化された栄養補助:ランダム化臨床試験
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
まとめ
リスクの高い入院患者に対する個別化された栄養補助は,標準的な病院の食事と比較して生存率を含む臨床結果を大幅に改善しました. これは 患者の回復のために 栄養学的スクリーニングと介入の重要性を強調しています
科学分野:
- 臨床栄養について
- 病院 医療
- 患者 の 結果
背景:
- 現在のガイドラインは,リスクの高い入院患者に対する栄養補助を推奨しています.
- これらの推奨を裏付ける証拠は限られており,急性疾患における栄養療法による潜在的な悪影響に関する懸念がある.
研究 の 目的:
- プロトコルによる個別化された栄養補助が栄養上のリスクのある入院患者の臨床結果を改善するかどうかをテストする.
主な方法:
- 栄養不良の入院患者の脆弱性,機能的アウトカム,回復に対する早期の栄養支援の効果 (EFFORT) は,多センターのランダム化研究でした.
- 栄養上のリスクのある2088人の医療従事者は,個別化された栄養補助または標準的な病院の食事を受けることを割り当てられました.
- 主要エンドポイントは,30日後の不良臨床結果の複合でした.
主要な成果:
- 個別的な栄養補助を受けた患者の23%は,対照群の27%に対して有害な結果を経験した (OR 0. 79, p=0. 023).
- 死亡率は介入群で低かった (7% vs 10%, OR 0.65, p=0. 011).
- 副作用の有意な違いは観察されなかった.
結論:
- リスクの高い入院患者の個別化された栄養補助は,生存率を含む臨床結果を改善します.
- 栄養上のリスクのある入院患者にとって 体系的な栄養学的スクリーニングと 適時な介入が不可欠です
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