Lancet sub-issue my country Air Force Military Medical University: Don't underestimate enteral nutrition, it can affect the prognosis of stroke!

Early enteral nutrition is critical for preventing malnutrition and improving outcomes in severe stroke patients , but previous trials have provided conflicting results on optimal nutritional strategies
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In order to compare the efficacy and safety of three enteral feeding strategies for severe stroke patients, experts from Xijing Hospital Affiliated to Air Force Military Medical University conducted a related study and the results were published in the journal Lancet Neurology

The Optimal Early Enteral Nutrition in Severe Stroke Study (OPENS) is a multicenter, investigator-initiated, prospective, open-label, randomized controlled trial with blinded evaluations in 16 tertiary grade-A hospitals and district-level general hospitals in western China
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Adult patients with acute major ischemic or hemorrhagic stroke (GCS ≤12 or NIHSS ≥11 on admission), expected to receive enteral nutrition for more than 7 days, were randomly assigned (1:1:1) by centralized Network randomized systematic assignment to total enteral nutrition (70-100% of estimated caloric needs), modified total enteral nutrition (full enteral nutrition plus agonists), or low-calorie enteral nutrition (40-100% of estimated caloric needs) 60%)
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The indicated nutrition started within 24 hours of enrollment and continued for 7 days
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The primary efficacy outcome was the proportion of participants with a poor outcome (modified Rankin Scale score ≥ 3) at day 90, and the prespecified primary safety outcome was mortality at day 90

During 2017-2020, 321 patients were randomly assigned (107 in each group), and 315 patients (175 [56%] men, median age 71 years, IQR 60-78) were included in the final analysis
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The study was terminated early on September 23, 2020, because a significant between-group difference was found in mortality

Further analysis showed that the 90-day mortality rate of low-calorie enteral nutrition was significantly higher than that of modified full enteral nutrition, with a nearly 2-fold increased risk (35/104 [34%] vs 18/105 [17%], OR=2.

references:

Safety and efficacy of three enteral feeding strategies in patients with severe stroke in China (OPENS): a multicentre, prospective, randomised, open-label, blinded-endpoint trial.