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.
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http://dx.doi.org/10.1016/j.clnu.2020.10.009 | DOI Listing |
BMC Surg
December 2024
General Surgery Section, Zherong County Hospital, No. 8 Shangqiao Road, Ningde, Fujian, 355300, China.
Background: To investigate the effect of postoperative supplementary parenteral nutrition (SPN) containing varying energy intake levels during the early postoperative period on the clinical outcomes of patients diagnosed with gastric cancer.
Methods: Data from 237 patients, who were diagnosed with gastric cancer between January 2016 and June 2022, were retrospectively analyzed. Patients were divided into 2 groups based on mean daily SPN energy intake: low (L-SPN; < 20 kcal/kg/day); and high (H-SPN; ≥ 20 kcal/kg/day).
BMC Infect Dis
December 2024
Shenzhen Third People's Hospital, National Clinical Research Centre for Infectious Disease, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China.
Background: Bacterial pathogens frequently encounter host-derived metabolites during their colonization and invasion processes, which can serve as nutrients, antimicrobial agents, or signaling molecules for the pathogens. The essential nutrient choline (Cho) is widely known to be utilized by a diverse range of bacteria and may undergo conversion into the disease-associated metabolite trimethylamine (TMA). However, the impact of choline metabolism on bacterial physiology and virulence remains largely unexplored.
View Article and Find Full Text PDFJ Geriatr Oncol
December 2024
Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia; School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia; Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Victoria 3000, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria 3010, Australia.
Introduction: Older patients with cancer (65 years and older) are a growing population with unique nutrition-and treatment-related issues that accelerate aging. Nutrition interventions attenuate nutritional decline, muscle loss, and risk of malnutrition and sarcopenia in patients with cancer, however the evidence for older patients with cancer is limited. The aim of this systematic review was to evaluate the efficacy of nutrition interventions on nutritional status, body weight/composition and clinical outcomes in older patients with cancer and to identify future research priority areas.
View Article and Find Full Text PDFOral Oncol
December 2024
Radiation Medicine Program, Princess Margaret Cancer Centre, M5G 2M9, Toronto, Ontario, Canada; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, M5G 2M9 Toronto, Ontario. Electronic address:
Objectives: This study aimed to develop a prediction model for feeding tube dependence in a large homogenous cohort of HPV-associated oropharyngeal squamous cell carcinoma (HPV + OPSCC) patients receiving chemoradiotherapy (CRT). We further aimed to externally validate three previously published feeding tube prediction models on this cohort.
Materials And Methods: p16-confirmed HPV + OPSCC patients treated with definitive CRT at a tertiary cancer centre between April 2017 and February 2022 were identified.
Pediatr Transplant
February 2025
Department of Surgery, University of California, San Francisco, California, USA.
Introduction: Following liver transplantation (LT), adequate nutrition is essential, as malnutrition may contribute to slower growth in pediatric patients and put patients at risk of complications following transplant. Avoidant Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by restrictive eating patterns that compromise nutrition. Patients with ARFID may have significant difficulty meeting nutritional needs due to fear of gastrointestinal distress, making it especially difficult to manage in patients following LT.
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