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. 2017 May 19;2017(5):CD011598. doi: 10.1002/14651858.CD011598.pub2

Comparison 2. All‐cause mortality ‐ maximum follow‐up.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 All‐cause mortality ‐ overall 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
2 All‐cause mortality ‐ bias 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
2.1 High risk of bias 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
2.2 Low risk of bias 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
3 All‐cause mortality ‐ mode of delivery 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
3.1 General nutrition support 7 1566 Risk Ratio (M‐H, Random, 95% CI) 0.99 [0.71, 1.36]
3.2 Fortified nutrition 2 290 Risk Ratio (M‐H, Random, 95% CI) 1.24 [0.61, 2.54]
3.3 Oral nutrition support 32 8501 Risk Ratio (M‐H, Random, 95% CI) 0.94 [0.77, 1.15]
3.4 Enteral nutrition 42 4212 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.75, 0.95]
3.5 Parenteral nutrition 51 8121 Risk Ratio (M‐H, Random, 95% CI) 0.99 [0.90, 1.09]
3.6 Mixed 7 480 Risk Ratio (M‐H, Random, 95% CI) 0.72 [0.37, 1.37]
4 All‐cause mortality ‐ medical specialty 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
4.1 Cardiology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.2 Medical gastro‐enterology and hepatology 13 622 Risk Ratio (M‐H, Random, 95% CI) 0.96 [0.77, 1.19]
4.3 Geriatrics 13 2547 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.67, 1.17]
4.4 Pulmonary disease 3 118 Risk Ratio (M‐H, Random, 95% CI) 0.44 [0.15, 1.28]
4.5 Endocrinology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.6 Infectious diseases 1 56 Risk Ratio (M‐H, Random, 95% CI) 1.61 [0.66, 3.92]
4.7 Rheumatology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.8 Haematology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.9 Nephrology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.10 Gastroenterologic surgery 50 4715 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.70, 1.12]
4.11 Trauma surgery 6 249 Risk Ratio (M‐H, Random, 95% CI) 0.86 [0.55, 1.34]
4.12 Ortopaedics 12 1196 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.61, 1.62]
4.13 Plastic, reconstructive, and aesthetic surgery 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.14 Vascular surgery 2 28 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.15 Transplant surgery 3 84 Risk Ratio (M‐H, Random, 95% CI) 0.54 [0.22, 1.31]
4.16 Urology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.17 Thoracic surgery 3 592 Risk Ratio (M‐H, Random, 95% CI) 0.71 [0.16, 3.22]
4.18 Neurological surgery 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.19 Oro‐maxillo‐facial surgery 1 32 Risk Ratio (M‐H, Random, 95% CI) 3.38 [0.15, 77.12]
4.20 Anaesthesiology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.21 Emergency medicine 11 5421 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.85, 1.12]
4.22 Psychiatry 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.23 Neurology 9 5448 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.59, 0.99]
4.24 Oncology 7 411 Risk Ratio (M‐H, Random, 95% CI) 1.03 [0.87, 1.21]
4.25 Dermatology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.26 Gynaecology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.27 Mixed 7 1651 Risk Ratio (M‐H, Random, 95% CI) 1.28 [0.94, 1.75]
5 All‐cause mortality ‐ based on adequacy of the amount of calories 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
5.1 Clearly adequate in intervention and clearly inadequate in control 28 7589 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.88, 1.09]
5.2 Inadequate in the experimental or adequate in the control 27 6824 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.82, 1.10]
5.3 Experimental group is overfed 10 974 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.69, 1.41]
5.4 Unclear intake in control or experimental 76 7783 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.81, 0.98]
6 All‐cause mortality ‐ different screening tools 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
6.1 NRS 2002 4 5064 Risk Ratio (M‐H, Random, 95% CI) 1.02 [0.87, 1.19]
6.2 MUST 1 146 Risk Ratio (M‐H, Random, 95% CI) 1.30 [0.60, 2.82]
6.3 MNA 2 117 Risk Ratio (M‐H, Random, 95% CI) 0.61 [0.12, 3.18]
6.4 SGA 3 1171 Risk Ratio (M‐H, Random, 95% CI) 1.41 [0.94, 2.10]
6.5 Other means 131 16672 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
7 All‐cause mortality ‐ participants characterised as 'at nutritional risk' due to one of the following conditions 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
7.1 Major surgery 62 5712 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.68, 1.04]
7.2 Stroke 4 5056 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.79, 1.05]
7.3 ICU participants including trauma 15 5626 Risk Ratio (M‐H, Random, 95% CI) 0.97 [0.85, 1.11]
7.4 Frail elderly participants with less severe conditions known to increase protein requirements 19 2385 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.65, 1.11]
7.5 Participants do not fall into one of the categories above 41 4391 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.84, 1.14]
8 All‐cause mortality ‐ participants characterised as 'at nutritional risk' due to one of the following criteria 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
8.1 BMI less than 20.5 kg/m2 2 247 Risk Ratio (M‐H, Random, 95% CI) 1.19 [0.58, 2.45]
8.2 Weight loss of at least 5% during the last three months 1 32 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
8.3 Weight loss of at least 10% during the last six months 3 124 Risk Ratio (M‐H, Random, 95% CI) 1.07 [0.11, 10.33]
8.4 Insufficient food intake during the last week (50% of requirements or less) 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
8.5 Participants characterised as 'at nutritional risk' by other means 135 22767 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
9 All‐cause mortality ‐ participants characterised as 'at nutritional risk' due to biomarkers or anthropometrics 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
9.1 Biomarkers 7 749 Risk Ratio (M‐H, Random, 95% CI) 0.40 [0.16, 1.00]
9.2 Anthropometric measures 12 1402 Risk Ratio (M‐H, Random, 95% CI) 0.79 [0.55, 1.11]
9.3 Both anthropometrics and biomarkers 3 75 Risk Ratio (M‐H, Random, 95% CI) 0.66 [0.14, 3.07]
9.4 Characterised by other means 119 20944 Risk Ratio (M‐H, Random, 95% CI) 0.94 [0.89, 1.00]
10 All‐cause mortality ‐ randomisation year 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
10.1 Before 1960 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
10.2 1960 to 1979 6 237 Risk Ratio (M‐H, Random, 95% CI) 1.07 [0.52, 2.23]
10.3 1980 to 1999 86 12055 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.86, 1.00]
10.4 After 1999 49 10878 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.81, 1.06]
11 All‐cause mortality ‐ trials where the intervention lasts fewer than three days compared with trials where the intervention lasts three days or more 141 23170 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
11.1 Three days or more 127 22394 Risk Ratio (M‐H, Random, 95% CI) 0.93 [0.88, 0.99]
11.2 Fewer than three days 12 699 Risk Ratio (M‐H, Random, 95% CI) 1.05 [0.72, 1.54]
11.3 Unknown 2 77 Risk Ratio (M‐H, Random, 95% CI) 0.25 [0.01, 5.00]
12 All‐cause mortality ‐ 'best‐worst case' scenario 141 23700 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.69, 0.85]
13 All‐cause mortality ‐ 'worst‐best case' scenario 141 23700 Risk Ratio (M‐H, Random, 95% CI) 1.09 [0.98, 1.23]
14 All‐cause mortality co‐interventions 141 23170 Risk Ratio (M‐H, Fixed, 95% CI) 0.92 [0.86, 0.98]
14.1 received nutrition support as co‐intervention 13 5475 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.82, 1.08]
14.2 did not receive nutrition support as co‐intervention 125 17462 Risk Ratio (M‐H, Fixed, 95% CI) 0.91 [0.85, 0.98]
14.3 delayed versus early nutrition support 3 233 Risk Ratio (M‐H, Fixed, 95% CI) 0.99 [0.53, 1.83]