Should the food intake of patients admitted to acute hospital services be routinely supplemented? A randomized placebo controlled trial.
BACKGROUND
Many patients admitted to acute hospital services are underweight or harbour vitamin deficiencies.


OBJECTIVE
To determine the effect on patient throughput of a policy of routine vitamin supplementation, and of early routine sipfeed supplementation in 'thin' patients (5-10% weight loss or body mass index 18-22).


METHODS
Factorial randomized placebo controlled trial of oral multivitamins from the first day of admission, and, after nutritional screening, of a nutritionally complete sipfeed from the second day in 'thin' patients.


METHODS
Acute medical, surgical and orthopaedic hospital services of a London teaching hospital.


METHODS
1561 patients admitted as emergencies were included in the vitamin study of which 549 were included in the sipfeed study.


METHODS
Length of hospital stay (LOS).


RESULTS
Offering multivitamins to acute admissions resulted in a mean change (reduction) in LOS of -0.4 days 95% CI (-2-1.2days). The results suggest greater reductions for those discharged after 10 days: mean change=-2.3 days 95% CI (-5.7 to 1.2). Sipfeed supplementation was associated with an increased mean length of stay 2.8 days 95% CI (-0.8-6.3). 18% of acute admissions were classified undernourished on the basis of BMI, MUAC or percent weight loss combined.


CONCLUSIONS
No benefit was observed for sipfeed intervention although a small benefit of less than one day is not excluded. Vitamin supplementation may have slight but economically important benefit.
Vlaming
S
S
Department of Human Nutrition, St Bartholomews, Royal London Hospital School of Medicine and Dentistry, UK.
Biehler
A
A
Hennessey
E M
EM
Jamieson
C P
CP
Chattophadhyay
S
S
Obeid
O A
OA
Archer
C
C
Farrell
A
A
Durman
K
K
Warrington
S
S
Powell-Tuck
J
J
D000328:Adult; D000368:Aged; D000886:Anthropometry; D019587:Dietary Supplements; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D002149:Energy Intake / Q000502:physiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009748:Nutrition Disorders / Q000628:therapy*; D009752:Nutritional Status / Q000187:drug effects*; D010349:Patient Compliance; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage* / Q000097:blood
D014815:Vitamins