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...

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Publicado en:Lancet Vol. 365; no. 9461; pp. 764 - 773
Autores principales: Dennis, M S, Lewis, S C, Warlow, C
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Lancet 2/26/2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2/26/2005
      vid: 365
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      pub: Lancet
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        10.1016/s0140-6736(05)17983-5
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        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
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