Network meta-analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery.

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dc.contributor.author Amer, MA en
dc.contributor.author Smith, MD en
dc.contributor.author Herbison, GP en
dc.contributor.author Plank, Lindsay en
dc.contributor.author McCall, JL en
dc.date.accessioned 2018-11-18T21:33:21Z en
dc.date.issued 2017-02 en
dc.identifier.issn 0007-1323 en
dc.identifier.uri http://hdl.handle.net/2292/44374 en
dc.description.abstract Three meta-analyses have summarized the effects of preoperative carbohydrate administration on postoperative outcomes in adult patients undergoing elective surgery. However, these studies could not account for the different doses of carbohydrate administered and the different controls used. Multiple-treatments meta-analysis allows robust synthesis of all available evidence in these situations.Article databases were searched systematically for RCTs comparing preoperative carbohydrate administration with water, a placebo drink, or fasting. A four-treatment multiple-treatments meta-analysis was performed comparing two carbohydrate dose groups (low, 10-44 g; high, 45 g or more) with two control groups (fasting; water or placebo). Primary outcomes were length of hospital stay and postoperative complication rate. Secondary outcomes included postoperative insulin resistance, vomiting and fatigue.Some 43 trials involving 3110 participants were included. Compared with fasting, preoperative low-dose and high-dose carbohydrate administration decreased postoperative length of stay by 0·4 (95 per cent c.i. 0·03 to 0·7) and 0·2 (0·04 to 0·4) days respectively. There was no significant decrease in length of stay compared with water or placebo. There was no statistically significant difference in the postoperative complication rate, or in most of the secondary outcomes, between carbohydrate and control groups.Carbohydrate loading before elective surgery conferred a small reduction in length of postoperative hospital stay compared with fasting, and no benefit in comparison with water or placebo. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries The British journal of surgery en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Postoperative Complications en
dc.subject Dietary Carbohydrates en
dc.subject Treatment Outcome en
dc.subject Length of Stay en
dc.subject Preoperative Care en
dc.subject Elective Surgical Procedures en
dc.subject Network Meta-Analysis en
dc.title Network meta-analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery. en
dc.type Journal Article en
dc.identifier.doi 10.1002/bjs.10408 en
pubs.issue 3 en
pubs.begin-page 187 en
pubs.volume 104 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 28000931 en
pubs.end-page 197 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Meta-Analysis en
pubs.subtype Review en
pubs.subtype Journal Article en
pubs.elements-id 603731 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Surgery Department en
dc.identifier.eissn 1365-2168 en
pubs.record-created-at-source-date 2016-12-22 en
pubs.dimensions-id 28000931 en


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