Abbott has announced a new study, published in the Journal of the American College of Surgeons, that demonstrated preoperative standard oral nutritional supplements (ONS) provide similar benefits as compared to immunonutrition (IN) supplements. Results from the study, a meta-analysis of published literature, showed that nutritional support provided by ONS resulted in similar postoperative rates of wound infections, risks of infectious and non-infectious postoperative complications, and the overall lengths of stay for patients compared to IN. Specifically, no statistically significant differences were found between ONS and IN for each of these key study endpoints.
Oral nutritional supplements, often in liquid form, provide extra protein and calories to supplement a person's diet. The use of ONS in the preoperative setting for surgical patients has not been well-characterized, particularly in comparison to IN. But IN supplements can be costly, often require a prescription, and suffer from poor palatability, all of which can reduce patient compliance to recommended preoperative nutritional supplementation.
"The results from this study are very informative and suggest that specialized immunonutritional supplements may not be necessary for surgical patients requiring preoperative nutritional support," said study co-author David Evans, M.D. Medical Director of Nutrition Support Services and Assistant Professor of Surgery at The Ohio State University. "With no discernible differences in patient outcomes, ONS is widely available in a variety of flavors and is typically less expensive. These advantages may allow improved patient nutritional compliance which is critical to achieving optimal outcomes and reduced complications post-surgery."
About the Study
The systematic literature review and meta-analysis, supported by Abbott, was designed to examine the effects on postoperative outcomes and complications comparing IN with 1) standard nutritional supplements and 2) regular diet with no supplements in the preoperative setting.
Randomized, prospective controlled trials comparing only preoperative nutrition interventions and reporting on clinically relevant postoperative outcomes (wound infections, infectious and non-infectious complications and length of hospital stay) were included.
Comparing IN vs. standard ONS, results demonstrated no statistical differences for:
- Rate of wound infections (Odds ratio [OR]= 0.97, 95% CI 0.45 to 2.11, P= 0.94)
- Risk of infectious complications (OR= 0.71, 95% CI 0.30 to 1.68, P= 0.44)
- Risk of non-infectious complications (OR= 1.25, 95% CI 0.64 to 2.43 P= 0.52)
- Length of stay (mean difference 0.07 days, 95% CI -2.29 to 2.43 P= 0.96)
Results comparing IN with non-supplemented standard diets demonstrated reductions in postoperative infectious complications and length of stay, but no improvements were seen for non-infectious complications or wound infections.
"This analysis and new data are a further demonstration of Abbott's continuing commitment to research that will advance the body of knowledge related to similar effects of nutritional supplementation in the preoperative setting," said Dr. Refaat Hegazi, Medical Director, Abbott Nutrition, co-author of the study and Affiliate Research Associate Professor, the Brody School of Medicine - East Carolina University. "The results are particularly enlightening and may result in increased recommendations for use of standard ONS in the preoperative setting based on the potential for greater patient adherence to their recommended nutritional regimen and resulting in improved outcomes."