A comparison of two different refeeding protocols and its effect on hand grip strength and refeeding syndrome : a randomized controlled clinical trial
© 2021. European Geriatric Medicine Society..
PURPOSE: Optimal refeeding protocols in older malnourished hospital patients remain unclear. We aimed to compare the effect of two different refeeding protocols; an assertive and a cautious protocol, on HGS, mortality and refeeding syndrome (RFS), in patients ≥ 65 years METHODS: Patients admitted under medical or surgical category and at risk of RFS, were randomized to either an enteral nutrition (EN) refeeding protocol of 20 kcal/kg/day, reaching energy goals within 3 days (intervention group), or a protocol of 10 kcal/kg/day, reaching goals within 7 days (control group). Primary outcome was the difference in hand grip strength (HGS) at 3 months follow-up, in an intention to treat analysis. RFS (phosphate < 0.65 mmol/L) during the hospital stay and mortality rates at 3 months were secondary outcomes.
RESULTS: A total of 85 patients were enrolled, with mean (SD) age of 79.8(7.4) and 54.1% female, 41 in the intervention group and 44 in the control group. HGS was similar at 3 months with mean change of 0.42 kg (95% CI - 2.52 to 3.36, p = 0.78). Serum phosphate < 0.65 mmol/L was seen in 17.1% in the intervention group and 9.3% in the control group, p = 0.29. There was no difference in mortality rates (39% vs 34.1%, p = 0.64). An indication of more respiratory distress was found in the intervention group, 53.6% vs 30.2%, p = 0.029.
CONCLUSION: A more assertive refeeding protocol providing 20 kcal/kg/day did not result in improved HGS measured 3 months after discharge compared with a cautious refeeding (10 kcal/kg/day) protocol. No difference in incidence of mortality or RFS was found.
TRIAL REGISTRATION: ClinicalTrials.gov Protocol Record 2017/FO148295, Registered: 21st of February, 2017.
| Errataetall: |
ErratumIn: Eur Geriatr Med. 2022 Oct;13(5):1231-1232. - PMID 35524006 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
European geriatric medicine - 12(2021), 6 vom: 04. Dez., Seite 1201-1212 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Olsen, Sissel Urke [VerfasserIn] |
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| Links: |
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| Themen: |
Enteral nutrition |
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| Anmerkungen: |
Date Completed 31.03.2022 Date Revised 31.05.2022 published: Print-Electronic ErratumIn: Eur Geriatr Med. 2022 Oct;13(5):1231-1232. - PMID 35524006 Citation Status MEDLINE |
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| doi: |
10.1007/s41999-021-00520-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM326345019 |
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| 100 | 1 | |a Olsen, Sissel Urke |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A comparison of two different refeeding protocols and its effect on hand grip strength and refeeding syndrome |b a randomized controlled clinical trial |
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| 500 | |a ErratumIn: Eur Geriatr Med. 2022 Oct;13(5):1231-1232. - PMID 35524006 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. European Geriatric Medicine Society. | ||
| 520 | |a PURPOSE: Optimal refeeding protocols in older malnourished hospital patients remain unclear. We aimed to compare the effect of two different refeeding protocols; an assertive and a cautious protocol, on HGS, mortality and refeeding syndrome (RFS), in patients ≥ 65 years METHODS: Patients admitted under medical or surgical category and at risk of RFS, were randomized to either an enteral nutrition (EN) refeeding protocol of 20 kcal/kg/day, reaching energy goals within 3 days (intervention group), or a protocol of 10 kcal/kg/day, reaching goals within 7 days (control group). Primary outcome was the difference in hand grip strength (HGS) at 3 months follow-up, in an intention to treat analysis. RFS (phosphate < 0.65 mmol/L) during the hospital stay and mortality rates at 3 months were secondary outcomes | ||
| 520 | |a RESULTS: A total of 85 patients were enrolled, with mean (SD) age of 79.8(7.4) and 54.1% female, 41 in the intervention group and 44 in the control group. HGS was similar at 3 months with mean change of 0.42 kg (95% CI - 2.52 to 3.36, p = 0.78). Serum phosphate < 0.65 mmol/L was seen in 17.1% in the intervention group and 9.3% in the control group, p = 0.29. There was no difference in mortality rates (39% vs 34.1%, p = 0.64). An indication of more respiratory distress was found in the intervention group, 53.6% vs 30.2%, p = 0.029 | ||
| 520 | |a CONCLUSION: A more assertive refeeding protocol providing 20 kcal/kg/day did not result in improved HGS measured 3 months after discharge compared with a cautious refeeding (10 kcal/kg/day) protocol. No difference in incidence of mortality or RFS was found | ||
| 520 | |a TRIAL REGISTRATION: ClinicalTrials.gov Protocol Record 2017/FO148295, Registered: 21st of February, 2017 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Enteral nutrition | |
| 650 | 4 | |a Hand grip strength | |
| 650 | 4 | |a Malnutrition | |
| 650 | 4 | |a Phosphate | |
| 650 | 4 | |a Refeeding syndrome | |
| 700 | 1 | |a Hesseberg, Karin |e verfasserin |4 aut | |
| 700 | 1 | |a Aas, Anne-Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Pripp, Are Hugo |e verfasserin |4 aut | |
| 700 | 1 | |a Ranhoff, Anette Hylen |e verfasserin |4 aut | |
| 700 | 1 | |a Bye, Asta |e verfasserin |4 aut | |
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