{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Baumgartner A"],"funding":["Swiss National Science Foundation","Forschungsrat of the Kantonsspital Aarau"],"pagination":["1843-1850"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC7547398"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["40(4)"],"pubmed_abstract":["<h4>Background</h4>In polymorbid patients with bronchopulmonary infection, malnutrition is an independent risk factor for mortality. There is a lack of interventional data investigating whether providing nutritional support during the hospital stay in patients at risk for malnutrition presenting with lower respiratory tract infection lowers mortality.<h4>Methods</h4>For this secondary analysis of a randomized clinical trial (EFFORT), we analyzed data of a subgroup of patients with confirmed lower respiratory tract infection from an initial cohort of 2028 patients. Patients at nutritional risk (Nutritional Risk Screening [NRS] score ≥3 points) were randomized to receive protocol-guided individualized nutritional support to reach protein and energy goals (intervention group) or standard hospital food (control group). The primary endpoint of this analysis was all-cause 30-day mortality.<h4>Results</h4>We included 378 of 2028 EFFORT patients (mean age 74.4 years, 24% with COPD) into this analysis. Compared to usual care hospital nutrition, individualized nutritional support to reach caloric and protein goals showed a similar beneficial effect of on the risk of mortality in the subgroup of respiratory tract infection patients as compared to the main EFFORT trial (odds ratio 0.47 [95%CI 0.17 to 1.27, p = 0.136] vs 0.65 [95%CI 0.47 to 0.91, p = 0.011]) with no evidence of a subgroup effect (p for interaction 0.859). Effects were also similar among different subgroups based on etiology and type of respiratory tract infection and for other secondary endpoints.<h4>Conclusion</h4>This subgroup analysis from a large nutrition support trial suggests that patients at nutritional risk as assessed by NRS 2002 presenting with bronchopulmonary infection to the hospital likely have a mortality benefit from individualized inhospital nutritional support. The small sample size and limited statistical power calls for larger nutritional studies focusing on this highly vulnerable patient population.<h4>Clinical trial registration</h4>Registered under ClinicalTrials.gov Identifier no. NCT02517476."],"journal":["Clinical nutrition (Edinburgh, Scotland)"],"pubmed_title":["Effect of nutritional support in patients with lower respiratory tract infection: Secondary analysis of a randomized clinical trial."],"pmcid":["PMC7547398"],"funding_grant_id":["1410.000.058","1410.000.044"],"pubmed_authors":["Hersberger L","Donze J","Pavlicek V","Rutishauser J","Brandle M","Bargetzi L","Cantone J","Schuetz P","Aujesky D","Bargetzi A","Gomes F","Hasenboehler F","Thomann R","Kaegi-Braun N","Mueller B","Hoess C","Tribolet P","Sigrist S","Henzen C","Bilz S","Baumgartner A","Stanga Z","Rodondi N"],"additional_accession":[]},"is_claimable":false,"name":"Effect of nutritional support in patients with lower respiratory tract infection: Secondary analysis of a randomized clinical trial.","description":"<h4>Background</h4>In polymorbid patients with bronchopulmonary infection, malnutrition is an independent risk factor for mortality. There is a lack of interventional data investigating whether providing nutritional support during the hospital stay in patients at risk for malnutrition presenting with lower respiratory tract infection lowers mortality.<h4>Methods</h4>For this secondary analysis of a randomized clinical trial (EFFORT), we analyzed data of a subgroup of patients with confirmed lower respiratory tract infection from an initial cohort of 2028 patients. Patients at nutritional risk (Nutritional Risk Screening [NRS] score ≥3 points) were randomized to receive protocol-guided individualized nutritional support to reach protein and energy goals (intervention group) or standard hospital food (control group). The primary endpoint of this analysis was all-cause 30-day mortality.<h4>Results</h4>We included 378 of 2028 EFFORT patients (mean age 74.4 years, 24% with COPD) into this analysis. Compared to usual care hospital nutrition, individualized nutritional support to reach caloric and protein goals showed a similar beneficial effect of on the risk of mortality in the subgroup of respiratory tract infection patients as compared to the main EFFORT trial (odds ratio 0.47 [95%CI 0.17 to 1.27, p = 0.136] vs 0.65 [95%CI 0.47 to 0.91, p = 0.011]) with no evidence of a subgroup effect (p for interaction 0.859). Effects were also similar among different subgroups based on etiology and type of respiratory tract infection and for other secondary endpoints.<h4>Conclusion</h4>This subgroup analysis from a large nutrition support trial suggests that patients at nutritional risk as assessed by NRS 2002 presenting with bronchopulmonary infection to the hospital likely have a mortality benefit from individualized inhospital nutritional support. The small sample size and limited statistical power calls for larger nutritional studies focusing on this highly vulnerable patient population.<h4>Clinical trial registration</h4>Registered under ClinicalTrials.gov Identifier no. NCT02517476.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021 Apr","modification":"2024-10-15T06:59:32.754Z","creation":"2020-10-29T15:56:59Z"},"accession":"S-EPMC7547398","cross_references":{"pubmed":["33081983"],"doi":["10.1016/j.clnu.2020.10.009"]}}