Effect of nutritional support in patients with lower respiratory tract infection: Secondary analysis of a randomized clinical trial
| Autor: | Jacques Donzé, Beat Mueller, Annika Bargetzi, Laura Bargetzi, Robert Thomann, Michael Brändle, Flavia Hasenboehler, Nicolas Rodondi, Vojtech Pavlicek, Jennifer Cantone, Annic Baumgartner, Zeno Stanga, Lara Hersberger, Drahomir Aujesky, Nina Kaegi-Braun, Stefan Bilz, Sarah Sigrist, Jonas Rutishauser, Claus Hoess, Pascal Tribolet, Christoph Henzen, Filomena Gomes, Philipp Schuetz |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty COVID19 610 Medicine & health 030209 endocrinology & metabolism Subgroup analysis Comorbidity Critical Care and Intensive Care Medicine law.invention Cohort Studies Randomized Control Trials 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 360 Social problems & social services law Respiratory infection Lower respiratory tract infection Internal medicine Risk of mortality medicine Clinical endpoint Humans Risk factor Nutritional support Respiratory Tract Infections Aged Outcome 030109 nutrition & dietetics Nutrition and Dietetics business.industry Malnutrition Odds ratio Middle Aged medicine.disease Hospitalization Female Randomized trial business Switzerland |
| Zdroj: | Clinical Nutrition Clinical Nutrition (Edinburgh, Scotland) Baumgartner, Annic; Hasenboehler, Flavia; Cantone, Jennifer; Hersberger, Lara; Bargetzi, Annika; Bargetzi, Laura; Kaegi-Braun, Nina; Tribolet, Pascal; Gomes, Filomena; Hoess, Claus; Pavlicek, Vojtech; Bilz, Stefan; Sigrist, Sarah; Brändle, Michael; Henzen, Christoph; Thomann, Robert; Rutishauser, Jonas; Aujesky, Drahomir; Rodondi, Nicolas; Donzé, Jacques; ... (2021). Effect of nutritional support in patients with lower respiratory tract infection: Secondary analysis of a randomized clinical trial. Clinical nutrition, 40(4), pp. 1843-1850. Elsevier 10.1016/j.clnu.2020.10.009 |
| DOI: | 10.7892/boris.147241 |
| Popis: | Summary Background In polymorbid patients with bronchopulmonary infection, malnutrition is an independent risk factor for mortality. There is a lack of interventional data investigating whether providing nutritional support during the hospital stay in patients at risk for malnutrition presenting with lower respiratory tract infection lowers mortality. Methods For this secondary analysis of a randomized clinical trial (EFFORT), we analyzed data of a subgroup of patients with confirmed lower respiratory tract infection from an initial cohort of 2028 patients. Patients at nutritional risk (Nutritional Risk Screening [NRS] score ≥3 points) were randomized to receive protocol-guided individualized nutritional support to reach protein and energy goals (intervention group) or standard hospital food (control group). The primary endpoint of this analysis was all-cause 30-day mortality. Results We included 378 of 2028 EFFORT patients (mean age 74.4 years, 24% with COPD) into this analysis. Compared to usual care hospital nutrition, individualized nutritional support to reach caloric and protein goals showed a similar beneficial effect of on the risk of mortality in the subgroup of respiratory tract infection patients as compared to the main EFFORT trial (odds ratio 0.47 [95%CI 0.17 to 1.27, p = 0.136] vs 0.65 [95%CI 0.47 to 0.91, p = 0.011]) with no evidence of a subgroup effect (p for interaction 0.859). Effects were also similar among different subgroups based on etiology and type of respiratory tract infection and for other secondary endpoints. Conclusion This subgroup analysis from a large nutrition support trial suggests that patients at nutritional risk as assessed by NRS 2002 presenting with bronchopulmonary infection to the hospital likely have a mortality benefit from individualized inhospital nutritional support. The small sample size and limited statistical power calls for larger nutritional studies focusing on this highly vulnerable patient population. Clinical trial registration Registered under ClinicalTrials.gov Identifier no. NCT02517476. |
| Databáze: | OpenAIRE |
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