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. 2012 Oct;60(10):1918-21.
doi: 10.1111/j.1532-5415.2012.04148.x. Epub 2012 Sep 24.

Does feeding tube insertion and its timing improve survival?

Joan M Teno  1 , Pedro L Gozalo, Susan L Mitchell, Sylvia Kuo, Ramona L Rhodes, Julie P W Bynum, Vincent Mor
Affiliations

Does feeding tube insertion and its timing improve survival?

Joan M Teno et al. J Am Geriatr Soc. 2012 Oct.

Abstract

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.

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Conflict of interest statement

Conflict of Interest

Drs. Teno, Gozalo, Kuo and Mor are affiliated with the Warren Alpert School of Medicine at Brown University; Dr.Mitchell is affiliated with Hebrew SeniorLife Institute for Aging Research; Dr. Rhodes is affiliated with University of Texas Southwestern Medical Center; Dr. Bynum is affiliated with The Dartmouth Institute at Dartmouth Medical School; none of these relationships pose a conflict of interest or potential conflict of interest.

Figures

Figure 1
Figure 1. Adjusted Survival Time Among Those With and Without a Feeding Tube Insertion
This survival curve compares the one-year survival from the MDS that noted assistance in eating among those residents with and without a PEG feeding tube inserted.
Figure 2
Figure 2. Adjusted Survival Time after Feeding Tube Insertion Stratified by Timing of Feeding Tube Insertion From Development of CPS Score of 6
Among those with a feeding tube, the one year survival from feeding tube insertion is depicted in 4 adjusted survival curves that include cohort of persons who had the feeding tube inserted one (n=569), two (n=310), three (n=205), and 4 or more months (n=872) after the NH resident need for eating assistance.
See this image and copyright information in PMC

References

    1. Mitchell SL, Lawson FM. Decision-making for long-term tube-feeding in cognitively impaired elderly people. CMAJ. 1999;160:1705–1709. - PMC - PubMed
    1. Carey TS, Hanson L, Garrett JM, et al. Expectations and outcomes of gastric feeding tubes. Am J Med. 2006;119:527 e511–526. - PubMed
    1. Finucane TE, Christmas C, Travis K. Tube feeding in patients with advanced dementia: A review of the evidence. JAMA. 1999;282:1365–1370. - PubMed
    1. Gillick MR. Rethinking the role of tube feeding in patients with advanced dementia. N Engl J Med. 2000;342:206–210. - PubMed
    1. Rudberg MA, Egleston BL, Grant MD, et al. Effectiveness of feeding tubes in nursing home residents with swallowing disorders. JPEN J Parenter Enteral Nutr. 2000;24:97–102. - PubMed

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