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

Comparison 4. Serious adverse event maximum follow‐up.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Serious adverse events ‐ overall 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
2 Serious adverse events ‐ bias 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
2.1 High risk of bias 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
2.2 Low risk of bias 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
3 Serious adverse events ‐ mode of delivery 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
3.1 General nutrition support 7 1544 Risk Ratio (M‐H, Random, 95% CI) 1.04 [0.76, 1.44]
3.2 Fortified nutrition 2 290 Risk Ratio (M‐H, Random, 95% CI) 1.24 [0.61, 2.54]
3.3 Oral nutrition support 33 8541 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.74, 1.07]
3.4 Enteral nutrition 49 4425 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.73, 0.91]
3.5 Parenteral nutrition 56 8263 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.90, 1.07]
3.6 Mixed 5 350 Risk Ratio (M‐H, Random, 95% CI) 0.74 [0.37, 1.48]
4 Serious adverse events ‐ by medical specialty 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
4.1 Cardiology 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.2 Medical gastroenterology and hepatology 13 706 Risk Ratio (M‐H, Random, 95% CI) 0.94 [0.75, 1.17]
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) 1.23 [0.52, 2.93]
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 59 4835 Risk Ratio (M‐H, Random, 95% CI) 0.83 [0.71, 0.97]
4.11 Trauma surgery 7 290 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) 0.98 [0.63, 1.51]
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 3 48 Risk Ratio (M‐H, Random, 95% CI) 0.5 [0.05, 4.67]
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) 0.47 [0.06, 3.62]
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) 0.88 [0.44, 1.78]
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) 0.96 [0.84, 1.10]
4.22 Psychiatry 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.23 Neurology 9 5426 Risk Ratio (M‐H, Random, 95% CI) 0.75 [0.58, 0.98]
4.24 Oncology 7 407 Risk Ratio (M‐H, Random, 95% CI) 1.02 [0.87, 1.20]
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 1655 Risk Ratio (M‐H, Random, 95% CI) 1.29 [0.97, 1.71]
5 Serious adverse events ‐ based on adequacy of the amount of calories 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
5.1 Clearly adequate in intervention and clearly inadequate in control 31 7623 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.86, 1.05]
5.2 Inadequate in the experimental or adequate in the control 29 7395 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.85, 1.05]
5.3 Experimental group is overfed 11 867 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.72, 1.19]
5.4 Unclear intake in control or experimental 81 7528 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.70, 0.94]
6 Serious adverse events ‐ different screening tools 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
6.1 NRS 2002 4 5064 Risk Ratio (M‐H, Random, 95% CI) 1.03 [0.89, 1.21]
6.2 MUST 1 124 Risk Ratio (M‐H, Random, 95% CI) 1.37 [0.64, 2.92]
6.3 MNA 2 117 Risk Ratio (M‐H, Random, 95% CI) 0.61 [0.12, 3.18]
6.4 SGA 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
6.5 Other means 145 18108 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.82, 0.95]
7 Serious adverse events ‐ participants characterised as 'at nutritional risk' due to one of the following conditions 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
7.1 Major surgery 72 5936 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.71, 0.94]
7.2 Stroke 8 5397 Risk Ratio (M‐H, Random, 95% CI) 0.75 [0.58, 0.98]
7.3 ICU participants including trauma 16 5667 Risk Ratio (M‐H, Random, 95% CI) 0.96 [0.84, 1.10]
7.4 Frail elderly participants with less severe conditions known to increase protein requirements 19 2385 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.65, 1.03]
7.5 Participants do not fall into one of the categories above 37 4028 Risk Ratio (M‐H, Random, 95% CI) 1.03 [0.92, 1.15]
8 Serious adverse events ‐ participants characterised as 'at nutritional risk' due to one of the following criteria 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
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) 0.84 [0.42, 1.67]
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 146 23010 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.84, 0.97]
9 Serious adverse events ‐ participants characterised as 'at nutritional risk' due to biomarkers or anthropometrics 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
9.1 Biomarkers 10 795 Risk Ratio (M‐H, Random, 95% CI) 0.37 [0.16, 0.85]
9.2 Anthropometric measures 12 1402 Risk Ratio (M‐H, Random, 95% CI) 0.76 [0.54, 1.08]
9.3 Both 3 75 Risk Ratio (M‐H, Random, 95% CI) 0.66 [0.14, 3.07]
9.4 Characterised by other means 127 21141 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.98]
10 Serious adverse events ‐ randomisation year 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
10.1 Before 1960 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
10.2 1960 to 1979 6 240 Risk Ratio (M‐H, Random, 95% CI) 1.18 [0.65, 2.14]
10.3 1980 to 1999 93 12128 Risk Ratio (M‐H, Random, 95% CI) 0.92 [0.86, 0.99]
10.4 After 1999 53 11045 Risk Ratio (M‐H, Random, 95% CI) 0.83 [0.72, 0.97]
11 Serious adverse events ‐ trials where the intervention lasts fewer than three days compared with trials where the intervention lasts three days or more 152 23413 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.85, 0.97]
11.1 Three days or more 138 22637 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.84, 0.97]
11.2 Less than three days 12 699 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.66, 1.23]
11.3 Unknown 2 77 Risk Ratio (M‐H, Random, 95% CI) 0.25 [0.01, 5.00]
12 Serious adverse events ‐ 'best‐worst case' scenario 152 24315 Risk Ratio (M‐H, Random, 95% CI) 0.72 [0.65, 0.79]
13 Serious adverse events ‐ 'worst‐best case' scenario 152 24082 Risk Ratio (M‐H, Random, 95% CI) 1.05 [0.94, 1.17]
14 Serious adverse events co‐interventions 152 23413 Risk Ratio (M‐H, Fixed, 95% CI) 0.89 [0.84, 0.95]
14.1 Received nutrition support as co‐intervention 12 5459 Risk Ratio (M‐H, Fixed, 95% CI) 0.93 [0.81, 1.06]
14.2 did not receive nutrition support as co‐intervention 132 17493 Risk Ratio (M‐H, Fixed, 95% CI) 0.88 [0.82, 0.94]
14.3 delayed versus early nutrition support 8 461 Risk Ratio (M‐H, Fixed, 95% CI) 1.09 [0.75, 1.59]
15 Serious adverse events ‐ 'best‐worse case' scenario (enteral nutrition) 46 4415 Risk Ratio (M‐H, Random, 95% CI) 0.62 [0.51, 0.75]
16 Serious adverse events ‐ 'worst‐best case' scenario (enteral nutrition) 46 4415 Risk Ratio (M‐H, Random, 95% CI) 0.81 [0.69, 0.96]