Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial

被引：16

作者：

Clarke, J ^{[1
]}

Cranswick, G ^{[1
]}

Dennis, MS ^{[1
]}

Flaig, R ^{[1
]}

Fraser, A ^{[1
]}

Grant, S ^{[1
]}

Gunkel, A ^{[1
]}

Hunter, J ^{[1
]}

Lewis, S ^{[1
]}

Perry, D ^{[1
]}

Soosay, V ^{[1
]}

Williams, C ^{[1
]}

Williamson, A ^{[1
]}

Young, A ^{[1
]}

Bulpitt, CJ ^{[1
]}

Grant, A ^{[1
]}

Murray, G ^{[1
]}

Sandercock, P ^{[1
]}

Anderson, N ^{[1
]}

Bahar, S ^{[1
]}

Hankey, G ^{[1
]}

Ricci, S ^{[1
]}

Bathgate, G ^{[1
]}

Chalmers, C ^{[1
]}

Cranswick, G ^{[1
]}

Dennis, MS ^{[1
]}

Farrell, B ^{[1
]}

Forbes, J ^{[1
]}

Ghosh, S ^{[1
]}

Langhorne, P ^{[1
]}

Levis, S ^{[1
]}

MacIntyre, J ^{[1
]}

McAteer, CA ^{[1
]}

O'Neill, P ^{[1
]}

Potter, J ^{[1
]}

Roberts, M ^{[1
]}

Warlow, C ^{[1
]}

Dennis, MS ^{[1
]}

Lewis, SC ^{[1
]}

Warlow, C ^{[1
]}

机构：

[1] Western Gen Hosp, Dept Clin Neurosci, Edinburgh EH4 2XU, Midlothian, Scotland

来源：

LANCET | 2005年 / 365卷 / 9461期

关键词：

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Undernutrition is common inpatients admitted with stroke. We aimed to establish whether the timing and route of enteral tube feeding after stroke affected patients' outcomes at 6 months. Methods The FOOD trials consist of three pragmatic multicentre randomised controlled trials, two of which included dysphagic stroke patients. In one trial, patients enrolled within 7 days of admission were randomly allocated to early enteral tube feeding or no tube feeding for more than 7 days (early versus avoid). In the other, patients were allocated percutaneous endoscopic gastrostomy (PEG) or nasogastric feeding. The primary outcome was death or poor outcome at 6 months. Analysis was by intention to treat. Findings Between Nov 1, 1996, and July 31, 2003, 859 patients were enrolled by 83 hospitals in 15 countries into the early versus avoid trial. Early tube feeding was associated with an absolute reduction in risk of death of 5 . 8% (95% CI -0 . 8 to 12 . 5, p=0.09) and a reduction in death or poor outcome of 1 . 2% (-4.2 to 6.6, p=0.7). In the PEG versus nasogastric tube trial, 321 patients were enrolled by 47 hospitals in 11 countries. PEG feeding was associated with an absolute increase in risk of death of 1 . 0% (-10 . 0 to 11 . 9, p=0 . 9) and an increased risk of death or poor outcome of 7.8% (0 . 0 to 15 . 5, p=0 . 05). Interpretation Early tube feeding might reduce case fatality, but at the expense of increasing the proportion surviving with poor outcome. Our data do not support a policy of early initiation of PEG feeding in dysphagic stroke patients.

引用

页码：764 / 772

页数：9

共 22 条

[1]

AXELSSON K, 1988, ACTA MED SCAND, V224, P217

[2] INTEROBSERVER AGREEMENT FOR THE ASSESSMENT OF HANDICAP IN STROKE PATIENTS [J].

BAMFORD, JM ;

SANDERCOCK, PAG ;

WARLOW, CP ;

SLATTERY, J .

STROKE, 1989, 20 (06) :828-828

[3]

BARER DH, J NEUROL NEUROSURG P, V52, P236

[4]

BATH PMW, 2002, COCHRANE LIB

[5] Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes [J].

Choi-Kwon, S ;

Yang, YH ;

Kim, EK ;

Jeon, MY ;

Kim, JS .

ACTA NEUROLOGICA SCANDINAVICA, 1998, 98 (03) :187-192

[6] Predicting outcome after acute and subacute stroke - Development and validation of new prognostic models [J].

Counsell, C ;

Dennis, M ;

McDowall, M ;

Warlow, C .

STROKE, 2002, 33 (04) :1041-1047

[7]

COUNSELL CE, 1998, THESIS U CAMBRIDGE C

[8] Effect of malnutrition after acute stroke on clinical outcome [J].

Davalos, A ;

Ricart, W ;

GonzalezHuix, F ;

Soler, S ;

Marrugat, J ;

Molins, A ;

Suner, R ;

Genis, D .

STROKE, 1996, 27 (06) :1028-1032

[9]

Dennis M, 2005, LANCET, V365, P755, DOI 10.1016/S0140-6736(05)17982-3

[10] Performance of a statistical model to predict stroke outcome in the context of a large, simple, randomized, controlled trial of feeding [J].

Dennis, M .

STROKE, 2003, 34 (01) :127-133

← 1 2 3 →