Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial.
Background: Undernutrition is common in patients admitted with stroke. We aimed to establish whether the timing and route of enteral tube feeding after stroke affected patients' outcomes at 6 months.Methods: The FOOD trials consist of three pragmatic multicentre randomised controlled trials, two of...
| Publicado en: | Lancet Vol. 365; no. 9461; pp. 764 - 773 |
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| Autores principales: | , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Lancet
2/26/2005
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106517490&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106517490 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 2/26/2005 vid: 365 iid: 9461 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 106517490 106517490 NLM15733717 2009025780 10.1016/s0140-6736(05)17983-5 NLM15733717 106517490 ppf: 764 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial. aug: au: Dennis, M S Lewis, S C Warlow, C affil: Department of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, UK sug: subj: Stroke Complications Deglutition Disorders Enteral Nutrition Methods Nutrition Disorders Therapy Stroke Mortality Clinical Assessment Tools Clinical Trials Confidence Intervals Gastrostomy Tubes Kaplan-Meier Estimator Logistic Regression Meta Analysis Nasoenteral Tubes Nutrition Disorders Complications Odds Ratio Prospective Studies Random Assignment Survival Analysis Wilcoxon Rank Sum Test Funding Source Human ab: Background: Undernutrition is common in patients admitted with stroke. We aimed to establish whether the timing and route of enteral tube feeding after stroke affected patients' outcomes at 6 months.Methods: The FOOD trials consist of three pragmatic multicentre randomised controlled trials, two of which included dysphagic stroke patients. In one trial, patients enrolled within 7 days of admission were randomly allocated to early enteral tube feeding or no tube feeding for more than 7 days (early versus avoid). In the other, patients were allocated percutaneous endoscopic gastrostomy (PEG) or nasogastric feeding. The primary outcome was death or poor outcome at 6 months. Analysis was by intention to treat.Findings: Between Nov 1, 1996, and July 31, 2003, 859 patients were enrolled by 83 hospitals in 15 countries into the early versus avoid trial. Early tube feeding was associated with an absolute reduction in risk of death of 5.8% (95% CI -0.8 to 12.5, p=0.09) and a reduction in death or poor outcome of 1.2% (-4.2 to 6.6, p=0.7). In the PEG versus nasogastric tube trial, 321 patients were enrolled by 47 hospitals in 11 countries. PEG feeding was associated with an absolute increase in risk of death of 1.0% (-10.0 to 11.9, p=0.9) and an increased risk of death or poor outcome of 7.8% (0.0 to 15.5, p=0.05).Interpretation: Early tube feeding might reduce case fatality, but at the expense of increasing the proportion surviving with poor outcome. Our data do not support a policy of early initiation of PEG feeding in dysphagic stroke patients. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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