在营养风险的住院患者中提供个性化的营养支持:随机临床试验
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
概括
与标准的医院饮食相比,对有风险的住院患者的个性化营养支持显著改善了临床结果,包括生存率. 这凸显了营养查和干预对改善患者康复的重要性.
科学领域:
- 临床营养
- 医院医学
- 患者的结果
背景情况:
- 目前的指导方针建议对有风险的住院患者提供营养支持.
- 支持这些建议的证据有限,担心急性疾病期间营养治疗的潜在负面影响.
研究的目的:
- 测试以协议为指导的个性化营养支持是否能改善营养风险的医疗住院患者的临床结果.
主要方法:
- 早期营养支持对营养不良住院患者的脆弱性,功能结果和恢复的影响 (EFFORT) 是一项多中心的随机研究.
- 在营养危险的2088名医疗患者被分配给个性化营养支持或标准的医院食物.
- 主要终点是30天后不良临床结果的复合.
主要成果:
- 在接受个性化营养支持的患者中,23%的患者出现了不良结果,而对照组的患者为27% (OR 0. 79, p=0. 023).
- 干预组的死亡率较低 (7%与10%,或0.65,p=0.011).
- 两组之间没有明显的副作用差异.
结论:
- 在危险医疗住院患者中,个性化营养支持改善了临床结果,包括生存率.
- 系统的营养查和及时干预对于营养风险的住院患者至关重要.
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