Nutritional status efficacy of early nutritional support in gastrointestinal care: A systematic review and meta-analysis

Table 1 Basic characteristics, patient characteristics, and outcome indicators of the included literatures

Ref.	Year	Design	Intention-to-treat total	Sample (E/D)	Surgery type	Age (yr)	Nutrition support mode	Outcomes
Sun et al[11]	2017	A prospective, randomized, single-blinded, controlled study	107	53/54	Major abdominal surgery	56 ± 10	Oral feeding	e, f
Pragatheeswarane et al[12]	2014	A randomized controlled study	120	60/60	Elective open bowel surgeries	46.5 ± 17.2	Oral feeding	d, e, f
Dag et al[13]	2011	A randomized controlled study	199	99/100	Elective open colorectal cancer surgery	62 (35-85)	Oral feeding	d, e, f
Fujii et al[14]	2014	A controlled study	120	62/58	Elective colorectal resection surgery	67.4 ± 11.7	Oral feeding	a, d, e, f
Liao et al[15]	2020	A randomized controlled study	41	21/20	Esophageal carcinoma surgery	57.2 ± 8.2	Enteral nutrition	d, f
Mi et al[16]	2012	A randomized controlled study	60	30/30	Gastrectomy	57.2 ± 9.5	Oral feeding	a, b, d, f
Mahmoodzadeh et al[17]	2015	A randomized controlled study	109	54/55	Gastrointestinal surgeries	64.2 ± 8.2	Oral feeding	d, f
Wang et al[18]	2005	A retrospective comparative study	454	227/227	Colorectal cancer resection surgery	63.5 ± 11.3	Enteral nutrition	d, e, f
Qiu et al[19]	2020	A retrospective comparative study	26	13/13	Severe acute pancreatitis treatment	33.4 ± 5.7	Enteral nutrition	a, c, d
Wang et al[20]	2015	A randomized controlled study	188	101/87	Esophagectomy	59.5 ± 8.4	Enteral nutrition	a, c, d, e, f
Klappenbach et al[21]	2013	A randomized controlled study	295	148/147	Abdominal elective surgery	37.3 ± 18.1	Oral feeding	d, e, f
Li et al[22]	2015	A randomized controlled study	300	150/150	Gastric cancer surgery	59.2 ± 9.7	Enteral nutrition	a, b, d, f
Zou et al[23]	2014	A retrospective comparative study	93	46/47	Severe acute pancreatitis treatment	46.5 (34.6-59.3)	Enteral nutrition	a, d, f
Barlow et al[24]	2011	A randomized controlled study	121	64/57	Upper gastrointestinal cancer surgery	64.0 ± 15.0	Eternal feeding	f

a: Albumin (g/L); b: Prealbumin (g/L); c: Total serum protein (g/L); d: Length of stay (d); e: Time to first defecation (h); f: Complications rate; E/D: Early/delayed.

Table 2 Risk of bias and quality assessment based on Cochrane Risk of Bias V2.0

Ref.	Randomization Process	Bias from defined interventions	Data missing bias	Data measurement offset	Optional reporting	Overall bias	Weight (%)
Sun et al[11]	Low	Low	Low	Some concerns	Low	Some concerns	8
Sun et al[11]	Low	Low	Low	Low	Low	Low	8
Pragatheeswarane et al[12]	Low	Low	Low	Low	Low	Low	8
Dag et al[13]	Low	Low	Low	Low	Low	Low	8
Fujii et al[14]	Low	Low	Low	Low	Low	Low	8
Liao et al[15]	Low	Low	Low	Some concerns	Low	Some concerns	8
Mi et al[16]	Low	Low	Low	Low	Low	Some concerns	8
Mahmoodzadeh et al[17]	Low	Some concerns	Low	Some concerns	Low	Some concerns	8
Wang et al[18]	Low	Some concerns	Low	Some concerns	Low	Some concerns	8
Qiu et al[19]	Low	Low	Low	Low	Low	Low	8
Wang et al[20]	Low	Low	Low	Low	Low	Low	8
Klappenbach et al[21]	Low	Low	Low	Low	Low	Low	8
Li et al[22]	Low	Some concerns	Low	Low	Low	Some concerns	8
Zou et al[23]	Low	Low	Low	Low	Low	Low	8
Barlow et al[24]	Low	Some concerns	Low	Some concerns	Low	Some concerns	8
Klappenbach et al[21]	Low	Low	Low	Low	Low	Low	8
Li et al[22]	Low	Low	Low	Low	Low	Low	8
Zou et al[23]	Low	Some concerns	Low	Low	Low	Some concerns	8
Barlow et al[24]	Low	Low	Low	Low	Low	Low	8
Klappenbach et al[21]	Low	Low	Low	Low	Low	Low	8

Table 3 Meta-analysis results of other nutritional indicators

Outcomes	Literature number	Analysis mode	P value	Effect size	Pooling value	Z, P value
Prealbumin	2	Fixed effect mode	0.22	mean difference	12.4776 (9.1231, 15.8320)	7.29, < 0.0001
Serum total protein	2	Random effect mode	0.0002	mean difference	5.2401 (-5.1833, 15.6635)	0.99, 0.3245