摘要
Background Undernutrition is common in hospital patients with stroke, can deve lop or worsen in hospital, and is associated with poor outcomes. We aimed to est ablish whether routine oral nutritional supplements improve outcome after stroke . Methods The FOOD trials are a family of three pragmatic, multicentre, randomis ed controlled trials.We measured the outcomes of stroke patients who could swall ow and who were randomly allocated normal hospital diet or normal hospital diet plus oral nutritional supplements until hospital discharge. The primary outcome was death or poor outcome (modified Rankin scale [MRS] grade 3-5), 6 months aft er enrolment, measured unaware of treatment allocation. Analysis was by intentio n to treat. Findings Between Nov 1, 1996, and July 31, 2003, 4023 patients were enrolled by 125 hospitals in 15 countries. Only 314 (8%) patients were judged t o be undernourished at baseline. Vital status and MRS at the end of the trial we re known for 4012 and 4004 patients, respectively. Supplemented diet was associa ted with an absolute reduction in risk of death of 0.7%(95%CI-1.4 to 2.7) and an increased risk of death or poor outcome of 0.7%(-2.3 to 3.8). Interpretati on We could not confirm the anticipated 4%absolute benefit for death or poor ou tcome from routine oral nutritional supplements for mainly well nourished stroke patients in hospital. Our results would be compatible with a 1%or 2%absolute benefit or harm from oral supplements. These results do not support a policy of routine oral supplementation after stroke.
Background Undernutrition is common in hospital patients with stroke, can deve lop or worsen in hospital, and is associated with poor outcomes. We aimed to est ablish whether routine oral nutritional supplements improve outcome after stroke . Methods The FOOD trials are a family of three pragmatic, multicentre, randomis ed controlled trials.We measured the outcomes of stroke patients who could swall ow and who were randomly allocated normal hospital diet or normal hospital diet plus oral nutritional supplements until hospital discharge. The primary outcome was death or poor outcome (modified Rankin scale [MRS] grade 3-5), 6 months aft er enrolment, measured unaware of treatment allocation. Analysis was by intentio n to treat. Findings Between Nov 1, 1996, and July 31, 2003, 4023 patients were enrolled by 125 hospitals in 15 countries. Only 314 (8%) patients were judged t o be undernourished at baseline. Vital status and MRS at the end of the trial we re known for 4012 and 4004 patients, respectively. Supplemented diet was associa ted with an absolute reduction in risk of death of 0.7%(95%CI-1.4 to 2.7) and an increased risk of death or poor outcome of 0.7%(-2.3 to 3.8). Interpretati on We could not confirm the anticipated 4%absolute benefit for death or poor ou tcome from routine oral nutritional supplements for mainly well nourished stroke patients in hospital. Our results would be compatible with a 1%or 2%absolute benefit or harm from oral supplements. These results do not support a policy of routine oral supplementation after stroke.
出处
《世界核心医学期刊文摘（神经病学分册）》
2005年第8期1-2,共2页
Digest of the World Core Medical Journals:Clinical Neurology
