Cited by 20Clinical Nutrition and GastroenterologyCentral Venous Catheters and HemodialysisHyperglycemia and glycemic control in critically ill and hospitalized patients

Mortality and overall and specific infection complication rates in patients who receive parenteral nutrition: systematic review and meta-analysis with trial sequential analysis

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Comerlato, Pedro H, Stefani, Joel, Viana, Luciana V·2021·The American Journal of Clinical Nutrition

Abstract

Background Parenteral nutrition (PN) is an available option for nutritional therapy and is often required in the hospital setting to overcome malnutrition. Objectives The aim of this study was to assess whether PN is associated with an increased risk of mortality or infectious complications in all groups of hospitalized patients compared with those receiving other nutritional support strategies. Methods For this systematic review and meta-analysis MEDLINE, Embase, Cochrane Central, Scopus, clinicaltrials.gov, and Web of Science were searched for randomized controlled trials (RCTs) and observational studies with parallel groups that explored the effect of PN on mortality and infectious complications, published until March 2021. Two independent reviewers extracted the data and assessed the risk of bias. Fixed-effects meta-analysis was performed to compare the groups from RCTs. Trial sequential analysis (TSA) was used to identify whether the results were sufficient to reach definitive conclusions. Results Of the 83 included studies that compared patients receiving PN with those receiving other strategies, 67 RCTs were included in the meta-analysis. PN was not associated with a higher risk of mortality (RR: 1.01; 95% CI: 0.95, 1.07). On the other hand, PN was associated with a higher risk of infectious events (RR: 1.23; 95% CI: 1.12, 1.36). PN was specifically associated with abdominal infection and catheter infection. The TSA showed that there were sufficient data to make numerical conclusions about mortality, any infectious event, and abdominal infectious complications. Conclusions This study suggests that although PN is not associated with greater mortality in hospitalized patients, it is associated with infectious complications. Through TSA, definite conclusions about survival and infection rates could be made.This review was registered at www.crd.york.ac.uk/prospero/ as CRD42018075599.

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Crossref · 10.1093/ajcn/nqab218

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Authors
Comerlato, P. H., Stefani, J., & Viana, L. V.
Affiliations
  • Universidade Federal do Rio Grande do Sul (BR)
  • Hospital de Clínicas de Porto Alegre (BR)
Corresponding author
Comerlato, Pedro H
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2021-10
Volume
114
Issue
4
Pages
1535-1545
ISSN
0002-9165 (ISSN-L)
OpenAlex
W3180927682
Cited by
20
References
110
Citations by year
2026: 9 · 2025: 5 · 2024: 3 · 2023: 1 · 2022: 2
FWCI
0.20
Type
journal article
Language
en
Open access
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
parenteral nutrition, mortality, infectious complications, catheter-related infection, intra-abdominal infection, nutritional support, hospitalized patients, trial sequential analysis
MeSH terms
Bacterial Infections, Humans, Mortality, Parenteral Nutrition, Risk Factors, Catheter-Related Infections

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