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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Vydané v:	Journal of the American Geriatrics Society (JAGS) Ročník 60; číslo 10; s. 1918 - 1921
Hlavní autori:	Teno, Joan M., Gozalo, Pedro L., Mitchell, Susan L., Kuo, Sylvia, Rhodes, Ramona L., Bynum, Julie P. W., Mor, Vincent
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Hoboken, NJ Blackwell Publishing Ltd 01.10.2012 Wiley-Blackwell Wiley Subscription Services, Inc
Predmet:	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
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Popis
Shrnutí:	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.
Bibliografia:	ark:/67375/WNG-61N950S7-H istex:FEFCD18D910120CAD7D4E5FBF4C1170E5D4DBF82 ArticleID:JGS4148 National Institute of Aging Research - No. R01AG024265; No. 1RC1AG036418-01 ObjectType-Article-1 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0002-8614 1532-5415 1532-5415
DOI:	10.1111/j.1532-5415.2012.04148.x