• S Vlaming, A Biehler, E M Hennessey, C P Jamieson, S Chattophadhyay, O A Obeid, C Archer, A Farrell, K Durman, S Warrington, and J Powell-Tuck.
• Department of Human Nutrition, St Bartholomews, Royal London Hospital School of Medicine and Dentistry, UK.
• Clin Nutr. 2001 Dec 1;20(6):517-26.

BackgroundMany patients admitted to acute hospital services are underweight or harbour vitamin deficiencies.ObjectivesTo determine the effect on patient throughput of a policy of routine vitamin supplementation, and of early routine sipfeed supplementation in 'thin' patients (5-10% weight loss or body mass index 18-22).DesignFactorial randomized placebo controlled trial of oral multivitamins from the first day of admission, and, after nutritional screening, of a nutritionally complete sipfeed from the second day in 'thin' patients.SettingAcute medical, surgical and orthopaedic hospital services of a London teaching hospital.Participants1561 patients admitted as emergencies were included in the vitamin study of which 549 were included in the sipfeed study.Main Outcome MeasureLength of hospital stay (LOS).ResultsOffering multivitamins to acute admissions resulted in a mean change (reduction) in LOS of -0.4 days 95% CI (-2-1.2days). The results suggest greater reductions for those discharged after 10 days: mean change=-2.3 days 95% CI (-5.7 to 1.2). Sipfeed supplementation was associated with an increased mean length of stay 2.8 days 95% CI (-0.8-6.3). 18% of acute admissions were classified undernourished on the basis of BMI, MUAC or percent weight loss combined.ConclusionsNo benefit was observed for sipfeed intervention although a small benefit of less than one day is not excluded. Vitamin supplementation may have slight but economically important benefit.Copyright 2001 Harcourt Publishers Ltd.

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