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Systematic Review of Postdischarge Oral Nutritional Supplementation in Patients Undergoing GI Surgery

From ¹ Colorectal Surgery, Torbay Hospital, Torquay, UK; ² Derriford Hospital, Plymouth, UK;³ University of Edinburgh, UK; and⁴ Department of Oral & Dental Science, University of Bristol, UK

Correspondence: Address correspondence to: Dr Stephen Lewis, Consultant Gastroenterologist, Derriford Hospital, PL6 8DH, UK.

Objective: To determine whether nutritional supplementation following hospital discharge in patients who undergo gastrointestinal (GI) surgery is benefical in specific outcome measures. Methods: A systematic review was conducted of randomized controlled trials comparing nutritional supplements vs a "standard care" regimen given to patients following discharge from hospital after GI surgery. Outcome measures were weight change, quality of life, clinical complications, fatigue, and hand grip strength. Results: Four studies were identified. Postdischarge oral nutritional supplements were found to be safe and increased energy intake, protein intake, and weight in patients after discharge from hospital. The greatest gains in weight were seen in malnourished patients. Little evidence was found that nutritional supplements reduce morbidity or improve quality of life, fatigue, or hand-grip strength. Only one study was methodologically adequate, and none were powered to detect differences in clinical complications. Conclusions: In patients who undergo GI surgery and receive nutritional supplements after discharge from hospital, little evidence of clinical benefit was found, principally through lack of robust data. All the studies were under-powered or not specifically designed to show benefit during this period. It is recommended that nutritional supplements be offered to malnourished patients or those at high risk of poor dietary intake at discharge from hospital.

Key Words: food supplementation • dietary supplement • digestive system surgical procedures

Nutrition in Clinical Practice, Vol. 24, No. 3, 388-394 (2009)
DOI: 10.1177/0884533609332175


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