The impact of fish oil (ω-3 fatty acids) intervention on infectious complications and cost-effectiveness for postoperative patients: systematic review (2010-2016)

Abstract

Objective To evaluate the impact of fish oil (ω-3 fatty acids) parenteral nutrition (PN) on outcomes for non-ICU postoperative patients. Methods PubMed, Embase, Cochrane, China National Know-ledge Infrastructure (CNKI) and Wanfang Database etc. were searched to retrieve the eligible studies published from January 2010 to June 2016. The studies included were randomized controlled trials (RCTs) that evaluated the effects of supplementation of fish oil(Omegawen) in PN regimens for postoperative patients on clinical outcomes. The methodological quality assessment was based on Jadad scale and Schulz allocation concealment tool. Meta-analysis was conducted by RevMan 5.3 software. Results 19 RCTs, 1 170 surgical patients, were included. Meta-analysis indicated that short-term fish oil supplementation significantly reduced the incidence of infectious complications [RR=0.44, 95% CI (0.31, 0.64), P<0.000 1] and shortened the length of hospital stay [MD=-0.85, 95% CI (-1.67, -0.03), P=0.04], while with no significant effect on mortality [RR=0.42, 95% CI (0.07, 2.63), P=0.36] and total expenditure of hospitalization [MD=-216.60, 95% CI(-718.94, 285.75), P=0.40]. Sensitivity analysis showed similar results. Conclusion According to existing evidence, fish oil in PN for surgical patients could reduce the incidence of postoperative infectious com-plications and shorten the length of hospital stay. Key words: Fish oil; Fatty acids, Omega-3 fatty acid; Parenteral nutrition; Postoperative patients; Meta-analysis; Incremental cost-effectiveness