Fifteen RCTs (n=753) were included.
Overall (12 trials, n=603), the risk of infection was significantly lower among patients who received early enteral nutrition (RR 0.45, 95% CI: 0.30, 0.66, P=0.00006). Statistical heterogeneity between the trials was significant (P=0.049). Seven of the 12 trials were in abdominal surgery patients (n=388), 2 in trauma patients (n=81), 2 in head-injury patients (n=114), and one in burns patients (n=20).
Overall (9 trials, n=520), no significant difference was shown in non-infectious complications (RR 0.82, 95% CI: 0.56, 1.19, P=0.3). Statistical heterogeneity between the trials was significant (P=0.047). Six of the 9 trials were in abdominal surgery patients (n=355), one in trauma patients (n=63), one in head-injury patients (n=82), and one in burns patients (n=20).
Overall (12 trials, n=489), the length of hospital stay was significantly shorter in the enteral nutrition group (WMD -2.22 days, 95% CI: -3.63, -0.81, P=0.002). Statistical heterogeneity between the trials was significant (P=0.0012). Eight of the 12 trials were in abdominal surgery patients (n=346), 2 in trauma patients (n=91), one in head-injury patients (n=32), and one in burns patients (n=20).
Overall (6 trials, n=296), no significant difference was shown in mortality (RR 0.74, 95% CI: 0.37, 1.48, P=0.4). Statistical heterogeneity between the trials was not significant (P=0.92). Three of the 6 trials were in abdominal surgery patients (n=131), one in trauma patients (n=63), one in head-injury patients (n=82), and one in burns patients (n=20).