Evidence map›Paper›PMID 16794908›Full record

SynthesisWorld journal of surgery2006

Postsurgical infections are reduced with specialized nutrition support.

Dan L Waitzberg, Hideaki Saito, Lindsay D Plank, Glyn G Jamieson, Palepu Jagannath, Tsann-Long Hwang, Juan M Mijares, David Bihari

Registry-linked trialAbstract readComparative StudyMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in World journal of surgery, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02655081 (Investigating the Use of a Preoperative High-Arginine Nutritional Supplement Prior to Radical Cystectomy), which is not on this map. Cited by 62 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 4 pooled it
9.4field-weighted citation impact, top 2% 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.

NCT02655081 phase2completednot on this mapstarted 2015, after this paper: background citation

Investigating the Use of a Preoperative High-Arginine Nutritional Supplement Prior to Radical Cystectomy

TypeinterventionalSponsorUniversity of PittsburghRan2015 to 2016Enrolled48ConditionsBladder CancerArmshigh arginine nutritional supplement (Nestle's Impact AR)
3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 4 syntheses or guidelines pooled it, 270 citations in OpenAlex.

  1. Pooled it
  2. PERIOPERATIVE CARE IN DIGESTIVE SURGERY: THE ERAS AND ACERTO PROTOCOLS - BRAZILIAN COLLEGE OF DIGESTIVE SURGERY POSITION PAPER.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024
    Guideline
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  4. COST-EFFECTIVENESS OF PERIOPERATIVE IMMUNONUTRITION IN GASTROINTESTINAL ONCOLOGIC SURGERY: A SYSTEMATIC REVIEW.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery
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2 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

8 authors at 8 institutions in 7 countries.

Dan L WaitzbergDepartment of Gastroenterology, LIM 35, University of São Paulo Medical School, Sao Paulo, Brazil, and Lilavati Hospital, Mumbai, India. dan@ganep.com.br
Hideaki Saito
Lindsay D Plank
Glyn G Jamieson
Palepu Jagannath
Tsann-Long Hwang
Juan M Mijares
David Bihari
Chang Gung University · TWLilavati Hospital & Research Centre · INPrince of Wales Hospital · AUTokyo Medical University · JPUniversidad Anáhuac · MXUniversidade de São Paulo · BRUniversity of Adelaide · AUUniversity of Auckland · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective was to examine the relationship between pre-, peri-, and postoperative specialized nutritional support with immune-modulating nutrients and postoperative morbidity in patients undergoing elective surgery.

methodsStudies were identified by searching MEDLINE, review article bibliographies, and abstracts and proceedings of scientific meetings. All randomized clinical trials in which patients were supplemented by the IMPACT formula before and/or after elective surgery and the clinical outcomes reported were included in the meta-analysis. Seventeen studies (n=2,305), 14 published (n=2,102), and 3 unpublished (n=203), fulfilled the inclusion criteria. Ten studies (n=1,392) examined the efficacy of pre- or perioperative IMPACT supplementation in patients undergoing elective surgery, whereas 7 (n=913) assessed postoperative efficacy. Fourteen of the studies (n=2,083) involved gastrointestinal (GI) surgical patients. Postoperative complications, mortality, and length of stay in hospital (LOS) were major outcomes of interest.

resultsIMPACT supplementation, in general, was associated with significant (39%-61%) reductions in postoperative infectious complications and a significant decrease in LOS in hospital by an average of 2 days. The greatest improvement in postoperative outcomes was observed in patients receiving specialized nutrition support as part of their preoperative treatment. In GI surgical patients, anastomotic leaks were 46% less prevalent when IMPACT supplementation was part of the preoperative treatment.

conclusionThis study identifies a dosage (0.5-1 l/day) and duration (supplementation for 5-7 days before surgery) of IMPACT that contributes to improved outcomes of morbidity in elective surgery patients, particularly those undergoing GI surgical procedures. The cost effectiveness of such practice is supported by recent health economic analysis. Findings suggest preoperative IMPACT use for the prophylaxis of postoperative complications in elective surgical patients.

Indexed as

Dietary SupplementsAdjuvants, ImmunologicDose-Response Relationship, DrugElective Surgical ProceduresEnteral NutritionFood, FormulatedHumansInfectionsLength of StayPerioperative CarePostoperative ComplicationsPreoperative CareAdjuvants, Immunologic

Identifiers

PMID16794908
OpenAlexW2014034051

What OpenQuestion holds

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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.