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- Title
Comparison of multi-modal early oral nutrition for the tolerance of oral nutrition with conventional care after major abdominal surgery: a prospective, randomized, single-blind trial.
- Authors
Da-Li Sun; Wei-Ming Li; Shu-Min Li; Yun-Yun Cen; Qing-Wen Xu; Yi-Jun Li; Yan-Bo Sun; Yu-xing Qi; Yue-ying Lin; Ting Yang; Qi-Ping Lu; Peng-Yuan Xu; Sun, Da-Li; Li, Wei-Ming; Li, Shu-Min; Cen, Yun-Yun; Xu, Qing-Wen; Li, Yi-Jun; Sun, Yan-Bo; Qi, Yu-Xing
- Abstract
<bold>Background& Aims: </bold>Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition.<bold>Methods: </bold>Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness.<bold>Results: </bold>One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P < 0.05). The median postoperative length of stay in the multimodal EON group was 8 days (6, 12) versus 10 days (7, 18) in the conventional care group (P < 0.001). The total cost of treatment and nutritional support were also less in the multi-modal early oral nutrition group (P < 0.001). The effectiveness was 84.9 and 79.9% in the multimodal EON and conventional care group, respectively (P = 0.475). However, the cost-effectiveness ratio was USD 537.6 (506.1, 589.3) and USD 637.8 (593.9, 710.3), respectively (P < 0.001).<bold>Conclusion: </bold>The multi-modal early oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery.<bold>Trial Registration: </bold>Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014.
- Subjects
ORAL hygiene; GASTROINTESTINAL function tests; ABDOMINAL surgery; BOWEL obstructions; COST effectiveness; PREVENTION of surgical complications; BIOLOGICAL assay; COLECTOMY; COMPARATIVE studies; DEFECATION; DIET therapy; DIGESTIVE organ surgery; GASTRECTOMY; LENGTH of stay in hospitals; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; POSTOPERATIVE care; RESEARCH; STATISTICAL sampling; SAMPLE size (Statistics); EVALUATION research; RANDOMIZED controlled trials; BLIND experiment; NUTRITIONAL status
- Publication
Nutrition Journal, 2017, Vol 16, p1
- ISSN
1475-2891
- Publication type
journal article
- DOI
10.1186/s12937-017-0228-7