LONG-TERM FOLLOW-UP OF CONSEQUENCES OF PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) TUBES IN NURSING-HOME PATIENTS

被引:125
作者
KAW, M [1 ]
SEKAS, G [1 ]
机构
[1] UNIV PITTSBURGH,SCH MED,DIV GASTROENTEROL & HEPATOL,PITTSBURGH,PA 15213
关键词
GASTROSTOMY; NUTRITION; DEMENTIA; MALNUTRITION;
D O I
10.1007/BF02087416
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PEG (percutaneous endoscopic gastrostomy) tubes are frequently placed in nursing home patients. The aim of this study was to assess retrospectively the long-term changes in functional and nutritional statuses, tube-related complications, and factors influencing survival in 46 nursing home residents, mean age 73.6 years (range 19-96). Functional status was evaluated by a standard rehabilitation medicine scale. Nutritional status was evaluated by serum albumin and cholesterol concentrations and by weight. PEG-related complications requiring hospitalization or emergency room or clinic evaluations were noted. Additionally, changes in resuscitation status were noted. The predominant indication for PEG placement was dementia (52%). At PEG placement, 48% of patients had total functional impairment Regardless of the severity of impairment, no patient's functional status improved after PEG. Nutritional status did not improve significantly. Mortality approached 50% and 60% at 12 and 18 months, respectively, and was significantly related to age, resuscitation status, and serum albumin concentration. All patients under 40 years of age at PEG survived, in contrast to 41.3% of patients over 40 years of age CP < 0.001). Sixty-three percent of patients who were ''full code'' at PEG placement survived, in contrast to 10% of ''no code'' patients (P < 0.001). Albumin greater than or equal to 3.5g/dl at PEG or thereafter was associated with improved survival (P < 0.001) as compared to albumin <3.5g/dl. PEG-related complications occurred in 34.7% of patients, and the first occurred four months after PEG. We conclude that realistic expectations of what PEG can accomplish be a factor in the decision to place a PEG tube in nursing home patients.
引用
收藏
页码:738 / 743
页数:6
相关论文
共 15 条
[1]   TUBE FEEDINGS IN ELDERLY PATIENTS - INDICATIONS, BENEFITS, AND COMPLICATIONS [J].
CIOCON, JO ;
SILVERSTONE, FA ;
GRAVER, LM ;
FOLEY, CJ .
ARCHIVES OF INTERNAL MEDICINE, 1988, 148 (02) :429-433
[2]  
FAY DE, 1991, AM J GASTROENTEROL, V86, P1604
[3]   PERCUTANEOUS ENDOSCOPIC GASTROSTOMY IN ELDERLY PATIENTS [J].
FINUCANE, P ;
ASLAN, SM ;
DUNCAN, D .
POSTGRADUATE MEDICAL JOURNAL, 1991, 67 (786) :371-373
[4]  
FOUTCH PG, 1988, AM J GASTROENTEROL, V83, P812
[5]  
FOUTCH PG, 1986, J CLIN GASTROENTEROL, V8, P10
[6]   GASTROSTOMY WITHOUT LAPAROTOMY - A PERCUTANEOUS ENDOSCOPIC TECHNIQUE [J].
GAUDERER, MWL ;
PONSKY, JL ;
IZANT, RJ .
JOURNAL OF PEDIATRIC SURGERY, 1980, 15 (06) :872-875
[7]  
GRANT JP, 1988, ANN SURG, V207, P590
[8]   PERCUTANEOUS ENDOSCOPIC GASTROSTOMIES - A PROSPECTIVE EVALUATION AND REVIEW OF THE LITERATURE [J].
KIRBY, DF ;
CRAIG, RM ;
TSANG, TK ;
PLOTNICK, BH .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 1986, 10 (02) :155-159
[9]   ALBUMIN LEVELS AS A PREDICTOR OF MORTALITY IN THE HEALTHY ELDERLY [J].
KLONOFFCOHEN, H ;
BARRETTCONNOR, EL ;
EDELSTEIN, SL .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1992, 45 (03) :207-212
[10]   PERCUTANEOUS ENDOSCOPIC GASTROSTOMY - INDICATIONS, SUCCESS, COMPLICATIONS, AND MORTALITY IN 314 CONSECUTIVE PATIENTS [J].
LARSON, DE ;
BURTON, DD ;
SCHROEDER, KW ;
DIMAGNO, EP .
GASTROENTEROLOGY, 1987, 93 (01) :48-52