Randomised clinical trial: enteral nutrition does not improve the long-term outcome of alcoholic cirrhotic patients with jaundice.

Abstract:

BACKGROUND:Malnutrition and jaundice are independent prognostic factors in cirrhosis. AIM:To assess the impact of enteral nutrition on the survival of alcoholic cirrhotic patients with jaundice but without acute alcoholic hepatitis. METHODS:The study was a multicentre prospective randomised controlled trial comparing effects of enteral nutrition vs. a symptomatic support in patients with alcoholic cirrhosis and jaundice (bilirubin ≥51 µmol/L) but without severe acute alcoholic hepatitis. A total of 99 patients were randomised to receive either the conventional symptomatic treatment (55 patients) or the symptomatic support associated with 35 kcal/Kg/day of enteral nutrition during 4 weeks followed by an oral nutritional support during 2 months (44 patients). Randomisation was stratified on nutritional status. One-year survival curves were compared using the Kaplan-Meier method and Logrank test. RESULTS:Populations in both arms were similar. One-year survival was similar in the overall population (27/44 patients (61.4%) in the enteral nutrition arm vs. 36/55 (65.5%) in the control arm; Logrank P = 0.60) and in the subgroup suffering from malnutrition [18/29 patients (62.1%) in the enteral nutrition arm vs. 20/32 (62.5%) in the control arm; Logrank P = 0.99]. There was no statistical difference for bilirubin, prothrombin rate, Child-Pugh score, albumin or nutritional assessment. Complications during treatment (bleeding, encephalopathy, infection) occurred in 23% of patients in the enteral nutrition group (10/44) vs. 16% (9/55) of the control patients (P = 0.59). CONCLUSION:Enteral nutrition does not improve the survival and hepatic or nutritional parameters of cirrhotic patients with jaundice.

journal_name

Aliment Pharmacol Ther

authors

Dupont B,Dao T,Joubert C,Dupont-Lucas C,Gloro R,Nguyen-Khac E,Beaujard E,Mathurin P,Vastel E,Musikas M,Ollivier I,Piquet MA

doi

10.1111/j.1365-2036.2012.05075.x

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

1166-74

issue

10

eissn

0269-2813

issn

1365-2036

journal_volume

35

pub_type

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