Evidence map›Paper›PMID 10203078›Full record

SynthesisAnnals of surgery1999

Enteral nutritional supplementation with key nutrients in patients with critical illness and cancer: a meta-analysis of randomized controlled clinical trials.

S D Heys, L G Walker, I Smith, O Eremin

Registry-linked trialOpen access · greenAbstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of surgery, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00559520 (The Role of Preoperative Oral Immunonutrition in Major Vascular Surgery), which is not on this map. Cited by 68 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 8 pooled it
26.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00559520 phase4completednot on this mapstarted 2002, after this paper: background citation

The Role of Preoperative Oral Immunonutrition in Major Vascular Surgery

TypeinterventionalSponsorCentre Hospitalier Universitaire de NiceRan2002 to 2011Enrolled250ConditionsUndernutritionArmsImpact, Oral Impact
3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 8 syntheses or guidelines pooled it, 486 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Guideline
  4. Guideline
  5. Guideline
  6. Enteral versus parenteral nutrition after gastrointestinal surgery: a systematic review and meta-analysis of randomized controlled trials in the English literature.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2008
    Pooled it
  7. Pooled it
  8. Guideline
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Effects of preoperative immunonutritionWorld journal of gastrointestinal surgery · 2025
    Article
  19. Article
  20. Review

8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

S D HeysDepartment of Surgery, University of Aberdeen, Scotland, United Kingdom.
L G Walker
I Smith
O Eremin
University of Aberdeen · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo conduct a meta-analysis of 11 randomized controlled trials comparing enteral nutritional support supplemented with key nutrients versus standard enteral nutritional support to determine effects on morbidity and mortality rates and hospital stay. BACKGROUND DATA: Recent studies have shown that malnutrition occurs in up to 30% of patients undergoing gastrointestinal surgery, resulting in an increased risk of postoperative complications and death. With the realization that key nutrients can modulate inflammatory, metabolic, and immune processes, enteral nutritional regimens (supplemented with large amounts of key nutrients) have been developed for clinical use.

methodsEleven prospective, randomized controlled trials evaluating 1009 patients treated with combinations of key nutrients (Impact, Immun-Aid) were evaluated. Outcome measures examined were the incidences of pneumonia, infectious complications, and death, and length of hospital stay. Meta-analyses were undertaken to obtain the odds ratio and 95% confidence interval for incidences of infectious complications, pneumonia, and death, and the weighted mean difference and 95% confidence interval for length of hospital stay.

resultsThe provision of nutritional support supplemented with key nutrients to patients with critical illness resulted in a decrease in infectious complications when compared with patients receiving standard nutritional support and a significant reduction in overall hospital stay. Similar results were documented in patients with gastrointestinal cancer. However, there were no differences between patient groups for either pneumonia or death.

conclusionsThis meta-analysis has demonstrated that nutritional support supplemented with key nutrients results in a significant reduction in the risk of developing infectious complications and reduces the overall hospital stay in patients with critical illness and in patients with gastrointestinal cancer. However, there is no effect on death. These data have important implications for the management of such patients.

Indexed as

Critical IllnessEnteral NutritionFood, FortifiedAbdominal AbscessGastrointestinal NeoplasmsHumansLength of StayPneumoniaRandomized Controlled Trials as TopicSepsisSurgical Wound Infection

Identifiers

PMID10203078
PMCPMC1191731
OpenAlexW1964738574

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.