Does Feeding Tube Insertion and Its Timing Improve Survival?

Objectives To examine survival with and without a percutaneous endoscopic gastrostomy (PEG) feeding tube using rigorous methods to account for selection bias and to examine whether the timing of feeding tube insertion affected survival. Design Prospective cohort study. Setting All U.S. nursing homes...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) Vol. 60; no. 10; pp. 1918 - 1921
Main Authors: Teno, Joan M., Gozalo, Pedro L., Mitchell, Susan L., Kuo, Sylvia, Rhodes, Ramona L., Bynum, Julie P. W., Mor, Vincent
Format: Journal Article
Language:English
Published: Hoboken, NJ Blackwell Publishing Ltd 01.10.2012
Wiley-Blackwell
Wiley Subscription Services, Inc
Subjects:
Aged, 80 and over
Bias
Biological and medical sciences
Cognitive impairment
Cohort analysis
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dementia
eating problems
feeding tubes
Female
Gastrostomy
General aspects
Humans
Intubation, Gastrointestinal - mortality
Male
Medical sciences
Miscellaneous
Multivariate analysis
Neurology
Nursing homes
Percutaneous endoscopic gastrostomy
Propensity
Prospective Studies
Public health. Hygiene
Public health. Hygiene-occupational medicine
Residents
Risk factors
Selection bias
survival
Survival Rate
Time Factors
timing of insertion
United States > US
Human
timing of insertion
Insertion
Feeding tube
eating problems
Eating disorder
Survival
feeding tubes
Improvement
Gerontology
Temporal study
Degenerative disease
Timing
Elderly
Dementia
Geriatrics
ISSN:0002-8614, 1532-5415, 1532-5415
Online Access:Get full text
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Summary:Objectives To examine survival with and without a percutaneous endoscopic gastrostomy (PEG) feeding tube using rigorous methods to account for selection bias and to examine whether the timing of feeding tube insertion affected survival. Design Prospective cohort study. Setting All U.S. nursing homes (NHs). Participants Thirty‐six thousand four hundred ninety‐two NH residents with advanced cognitive impairment from dementia and new problems eating studied between 1999 and 2007. Measurements Survival after development of the need for eating assistance and feeding tube insertion. Results Of the 36,492 NH residents (88.4% white, mean age 84.9, 87.4% with one feeding tube risk factor), 1,957 (5.4%) had a feeding tube inserted within 1 year of developing eating problems. After multivariate analysis correcting for selection bias with propensity score weights, no difference was found in survival between the two groups (adjusted hazard ratio (AHR) = 1.03, 95% confidence interval (CI) = 0.94–1.13). In residents who were tube‐fed, the timing of PEG tube insertion relative to the onset of eating problems was not associated with survival after feeding tube insertion (AHR = 1.01, 95% CI = 0.86–1.20, persons with a PEG tube inserted within 1 month of developing an eating problem versus later (4 months) insertion). Conclusion Neither insertion of PEG tubes nor timing of insertion affect survival.
Bibliography:ark:/67375/WNG-61N950S7-H
istex:FEFCD18D910120CAD7D4E5FBF4C1170E5D4DBF82
ArticleID:JGS4148
National Institute of Aging Research - No. R01AG024265; No. 1RC1AG036418-01
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ISSN:0002-8614
1532-5415
1532-5415
DOI:10.1111/j.1532-5415.2012.04148.x