PAM1 ORAL NUTRITIONAL SUPPLEMENTS REDUCE MORTALITY AND LENGTH OF STAY IN MALNOURISHED HOSPITALIZED PATIENTS: A META-ANALYSIS

Abstract

Malnutrition is commonin hospitalized patientsand costly to the health care system. Usually,it is related to poor clinical outcomes, increasingmortality and worsening patients’ quality of life. Oral nutrition supplements (ONS) are low cost and simple treatment for at risk of malnutrition ormalnourished inpatients. This metanalysis assesseswhether ONS improve clinical outcomes in hospitalized malnourished or at risk for malnutritionpatients. RCTs evaluating ONS in malnourished inpatients were retrieved from MEDLINE, EMBASE, LILACS and Cochrane databases that were searched from inception until October 2018. There was no language restriction. We extracted and combined data from studies that reported mortality, length of stay, complications and readmissions. A random-effects, meta-analytic model was applied in all calculations. Cochrane collaboration tool and GRADE were used to assess bias and certainty of the outcomes of the included studies, respectively. Thismeta-analysis isregistered in PROSPERO (CRD42018108245). We included 22 RCTs. ONS reduced mortality and length of stay (RR: 0.63; 95% CI, 0.46 - 0.85; p=0.003, and MD: -0.45; 95%CI, -0.83 - -0.08; p=0.02, respectively). Complication rate and hospital readmissions showed no difference among groups (RR: 0.95; 95% CI, 0.82 - 1.10; p=0.47; and RR: 0.89; 95%CI, 0.71 – 1.13; p=0.34, respectively).Most outcomes, except complications,had low or very low GRADE assessment. ONS may reduce mortality and the length of stay of malnourished or at risk for malnutrition patients. Better quality of evidence is needed.