The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia

Yutaka Suzuki¹, Mitsuyoshi Urashima², Masaki Izumi³, Yasuhiko Ito⁴, Nobuyuki Uchida⁵, Shingo Okada⁶, Hiromi Ono⁷, Satoshi Orimo⁸, Takayuki Kohri⁹, Hiroaki Shigoka¹⁰, Shuzo Shintani¹¹, Yukiko Tanaka¹², Atsushi Yoshida¹³, Masashi Ijima¹⁴, Toru Ito¹⁵, Takao Endo¹⁶, Hitoshi Okano¹⁷, Michio Maruyama¹⁸, Tsuyoshi Iwase¹⁹, Tsutomu Kikuchi²⁰, Michiaki Kudo²¹, Mikako Takahashi²², Satoshi Goshi²³, Tatsuya Mikami²⁴, Satoyoshi Yamashita²⁵, Kazuhiro Akiyama²⁶, Tetsushi Ogawa²⁷, Tomoko Ogawa²⁸, Shigeki Ono²⁹, Shigeru Onozawa³⁰, Junya Kobayashi³¹, Masami Matsumoto³², Toshifumi Matsumoto³³, Kazuaki Jomoto³⁴, Akihiro Mizuhara³⁵, Yukio Nishiguchi³⁶, Shinji Nishiwaki³⁷, Masahiko Aoki³⁸, Izumi Ishizuka³⁹, Toshiroh Kura⁴⁰, Masato Murakami⁴¹, Akihiko Murakami⁴², Tomoyuki Ohta⁴³, Koji Onishi⁴⁴, Masato Nakahori⁴⁵, Tsuyotoshi Tsuji⁴⁶, Ko Tahara⁴⁷, Ikuta Tanaka⁴⁸, Kazuhiko Kitagawa⁴⁹, Makoto Shimazaki⁵⁰, Takanori Fujiki⁵¹, Toshiro Kusakabe⁵², Takao Iiri⁵³, Shuichirou Kitahara⁵⁴, Akira Horiuchi⁵⁵, Hitoshi Suenaga⁵⁶, Naohiro Washizawa⁵⁷, Masahiko Suzuki⁵⁸

Affiliations

¹ Department of Surgery, International University of Health and Welfare Hospital 537-3 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan.
² Department of Molecular Epidemiology, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
³ Department of Internal Medicine, Tokyo-Musashino Hospital, 4-11-11 Komone, Itabashi-ku, Tokyo, 173-0037, Japan.
⁴ Suzuki Internal Medicine Clinic, 4-5-43 Heiwadai, Nagareyama-shi, Chiba, 270-0157, Japan.
⁵ Department of Surgery, Haramachi Red-Cross Hospital, 698 Haramachi, Higashi-Agatsuma-machi, Gunma, 377-0882, Japan.
⁶ Department of Surgery, Kitamihara Clinic, 18-350 Ishikawa-cho, Hakodate-shi, Hokkaido, 041-0802, Japan.
⁷ Department of Internal Medicine, Seiwa Memorial Hospital, 5-1-1 Kotoni1,Nishi-ku, Sapporo-shi, Hokkaido, 063-0811, Japan.
⁸ Department of Neurology, Kanto Central Hospital, 6-25-1 Kami-Yoga, Setagaya-ku, Tokyo, 158-8531, Japan.
⁹ Department of Surgery, Tone chuou hospital, 1855-1 Higashiharashinmachi, Numata-shi, Gunma, 378-005, Japan.
¹⁰ Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
¹¹ Department of Neurology, JA Toride Medical Center, 2-1-1 Hongoh, Toride City, Ibaraki, 302-0022, Japan.
¹² The Internal Department, Uchida hospital, 345-1 Kuyahara, Numata-shi, Gunma, 378-0005, Japan.
¹³ Center for Digestive and Liver Diseases, Ohfuna Chuo Hospital, 6-2-24 Ohfuna, Kamakura, Kanagawa, 247-0056, Japan.
¹⁴ Department of Internal Medicine, Isesaki Municipal Hospital, 12-1 Tsunatorihonmachi, Isesaki-shi, Gunma, 372-0812, Japan.
¹⁵ Department of Surgery, Nakamura Memorial Hospital, Nishi-14,Minami-1,Chuo-ku, Sapporo-shi, Hokkaido, 060-8570, Japan.
¹⁶ Department of Gastroenterology, Sapporo Shirakaba-dai hospital, 2-18-7-26 Tukisamu-Higash,Toyohira-ku, Sapporo-shi, Hokkaido, 062-0052, Japan.
¹⁷ Department of Gastroenterology, Okano clinic, 3 Higashida-cho,Jodoji, Sakyo-ku, Kyoto-shi, Kyoto, 606-8411, Japan.
¹⁸ Deaprtment of Surgery, Tokyo Metropolitan Ohkubo Hospital, 2-44-1 Kabukicho, Sinnjyukuku, Tokyo, 160-8488, Japan.
¹⁹ Department of Internal medicine, Kyoto kujo hospial, 10 Karahashi Rajomon-cho Minami-ku, Kyoto-shi, Kyoto, 601-8485, Japan.
²⁰ Department of Surgery, Kanazawa Nishi Hospital, 6-15-41 Ekinishihonmachi, Kanazawa-shi, Ishikawa, 920-0025, Japan.
²¹ Department of Surgery, Onishi Hospital, 139-1 Onishi, Fujika-shi, Gunma, 370-1401, Japan.
²² Department of Internal Medicine, Tsuruika Kyouritsu Hospotal, 9-34 Fumizono-cho, Tsuruoka-shi, Yamagata, 997-0816, Japan.
²³ Department of Gastroenterology and Hepatology, Japan Agricultural Cooperatives of Niigata Joetsu General Hospital, 148-1 Daidoufukuda, Joetsu-shi, Niigata, 943-8507, Japan.
²⁴ Department of Gastroenterology, Hirosaki Municipal Hospital, 1-8-3 Ohmachi, Hirosaki- shi, Aomori, 036-8004, Japan.
²⁵ Department of Gastroenterology, Social Insurance Shimonoseki Welfare Hospital, 3-3-8 Kamishinchi, Shimonoseki-shi, Yamaguchi, 750-0061, Japan.
²⁶ Department of Surgery, Tokatsu-clinic Hospital, 865-2 Hinokuchi, Matsudo-shi, Chiba, 271-0067, Japan.
²⁷ Department of Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi-shi, Gunma, 371-0014, Japan.
²⁸ Department of Neurology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara-shi, Tochigi, 329-2763, Japan.
²⁹ Department of Gastroenterology, Ako City Hospital, 1090 Nakahiro, Ako-shi, Hyogo, 678-0232, Japan.
³⁰ Department of HomeCareMedicine, Kameda Medical Center, 929 Higashicho, Kamogawa-shi, Chiba, 292-8601, Japan.
³¹ Department of Surgery, Fujiyoshida Municipal Hospital, 6530 Kamiyoshida, Fujiyoshida-shi, Yamanashi, 403-0005, Japan.
³² Department of Internal Medicine, Nara Prefectural Gojo Hospital, 5-2-59 Noharanishi, Gojo-shi, Nara, 637-8511, Japan.
³³ Department of Surgery, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, Oita, 874-0011, Japan.
³⁴ Director, Jomoto Gastroenteric & Internal Medical Clinic, 5-8-9 Kuhonnji, Kumamoto-shi, Kumamoto, 862-0976, Japan.
³⁵ Department of Cardiology and Vascular Surgery, Higashi-Washinomiya Hospital, 3-9-3 Sakurada, Kuki-shi, Saitama, 340-0203, Japan.
³⁶ Department of Gastro-enterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-Hondori Miyakojima-ku, Osaka-shi, Osaka, 534-0021, Japan.
³⁷ Department of Internal Medicine, Nishimino Kosei Hospital, 986 Oshikoshi, Yoro-gun Yoro-cho, Gifu, 503-1394, Japan.
³⁸ Department of Surgery, Ohtawara Red Cross Hospital, 2-7-3 Sumiyoshi-cho, Ohtawara-shi, Tochigi, 324-8686, Japan.
³⁹ Department of Internal medicine, Kohka Public Hospital, 3-39 Rokushin,Minakuchi-cho, Kohka-shi, Shiga, 528-0014, Japan.
⁴⁰ Department of Gastroenterology, Naganuma Municipal Hospital, 2-2-1 Chuo-minami,Naganuma-cho, Yubari-gun, Hokkaido, 069-1332, Japan.
⁴¹ Department of Internal Medicine, Murakami Memorial Hospital, 739 Oomachi, Saijo-shi, Ehime, 793-0030, Japan.
⁴² Endoscopy unit, Iwate prefectural central Hospital, 1-4-1 ueda, Morioka-shi, Iwate, 020-0066, Japan.
⁴³ Center for Gastroenterology, Sapporo Higashi-Tokushukai Hospital, 3-1 North33-East14,Higashi-ku, Sapporo-shi, Hokkaido, 065-0033, Japan.
⁴⁴ Internal Medicine, Matsue Seikyo General Hospital, 8-8-8 Nishitsuda, Matsue-shi, Shimane, 690-8522, Japan.
⁴⁵ Digestive Endoscopy Center, Sendai Kousei Hospital, 4-8 Hirose-machi,Aoba-ku, Sendai-shi, Miyagi, 980-0873, Japan.
⁴⁶ Department of Gastroenterology, Akita City Hospital, 4-30 Kawamotomatsuoka-cho, Akita-shi, Akita, 010-0933, Japan.
⁴⁷ Department of Surgery, Kure Kyosai Hospital, 2-3-28 Nishichuou, Kure-shi, Hiroshima, 737-8505, Japan.
⁴⁸ Department of Gastroenterology, Japan Red Cross Date General Hospital, 81 Suenaga, Date-shi, Hokkaido, 052-8511, Japan.
⁴⁹ Department of Surgery, Tsuchida Hospital, 2-11,South-21,West-9,Chuo-ku, Sapporo-shi, Hokkaido, 064-0921, Japan.
⁵⁰ Department of Gastroenterology, Hirano General Hospital, 176-5 Kurono, Gifu-shi, Gifu, 501-1192, Japan.
⁵¹ Department of Gastroenterology, Japanese Red Cross Society Shimizu Hospital, 2-2 minami,Shimizu-cho, Kamikawa-gun, Hokkaido, 089-0195, Japan.
⁵² Department of Gastroenterology, Higashi Sapporo Hospital, 3-3-7-35 Higashi-Sapporo,Shiroishi-ku, Sapporo-shi, Hokkaido, 003-8585, Japan.
⁵³ Department of Gastroenterology, Tachikawa General Hospital, 3-2-11 Kandamachi, Nagaoka-shi, Niigata, 940-8621, Japan.
⁵⁴ Department of Pediatric Surgery, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano-shi, Nagano, 380-8582, Japan.
⁵⁵ Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane-shi, Nagano, 399-4117, Japan.
⁵⁶ Department of Surgery, Hitachikoh Hospital, 3-4-22 Kujichou, Hitachi-shi, Ibaraki, 319-1222, Japan.
⁵⁷ Nutritional Therapy Center, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
⁵⁸ Department of Neurology, The Jikei University School of Medicine, Aoto Hospital, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan.

PMID: 27785173
PMCID: PMC5051036
DOI: 10.4021/gr392w

The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia

Yutaka Suzuki et al. Gastroenterology Res. 2012 Feb.

. 2012 Feb;5(1):10-20.

doi: 10.4021/gr392w. Epub 2012 Jan 20.

Authors

Affiliations

¹ Department of Surgery, International University of Health and Welfare Hospital 537-3 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan.
² Department of Molecular Epidemiology, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
³ Department of Internal Medicine, Tokyo-Musashino Hospital, 4-11-11 Komone, Itabashi-ku, Tokyo, 173-0037, Japan.
⁴ Suzuki Internal Medicine Clinic, 4-5-43 Heiwadai, Nagareyama-shi, Chiba, 270-0157, Japan.
⁵ Department of Surgery, Haramachi Red-Cross Hospital, 698 Haramachi, Higashi-Agatsuma-machi, Gunma, 377-0882, Japan.
⁶ Department of Surgery, Kitamihara Clinic, 18-350 Ishikawa-cho, Hakodate-shi, Hokkaido, 041-0802, Japan.
⁷ Department of Internal Medicine, Seiwa Memorial Hospital, 5-1-1 Kotoni1,Nishi-ku, Sapporo-shi, Hokkaido, 063-0811, Japan.
⁸ Department of Neurology, Kanto Central Hospital, 6-25-1 Kami-Yoga, Setagaya-ku, Tokyo, 158-8531, Japan.
⁹ Department of Surgery, Tone chuou hospital, 1855-1 Higashiharashinmachi, Numata-shi, Gunma, 378-005, Japan.
¹⁰ Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
¹¹ Department of Neurology, JA Toride Medical Center, 2-1-1 Hongoh, Toride City, Ibaraki, 302-0022, Japan.
¹² The Internal Department, Uchida hospital, 345-1 Kuyahara, Numata-shi, Gunma, 378-0005, Japan.
¹³ Center for Digestive and Liver Diseases, Ohfuna Chuo Hospital, 6-2-24 Ohfuna, Kamakura, Kanagawa, 247-0056, Japan.
¹⁴ Department of Internal Medicine, Isesaki Municipal Hospital, 12-1 Tsunatorihonmachi, Isesaki-shi, Gunma, 372-0812, Japan.
¹⁵ Department of Surgery, Nakamura Memorial Hospital, Nishi-14,Minami-1,Chuo-ku, Sapporo-shi, Hokkaido, 060-8570, Japan.
¹⁶ Department of Gastroenterology, Sapporo Shirakaba-dai hospital, 2-18-7-26 Tukisamu-Higash,Toyohira-ku, Sapporo-shi, Hokkaido, 062-0052, Japan.
¹⁷ Department of Gastroenterology, Okano clinic, 3 Higashida-cho,Jodoji, Sakyo-ku, Kyoto-shi, Kyoto, 606-8411, Japan.
¹⁸ Deaprtment of Surgery, Tokyo Metropolitan Ohkubo Hospital, 2-44-1 Kabukicho, Sinnjyukuku, Tokyo, 160-8488, Japan.
¹⁹ Department of Internal medicine, Kyoto kujo hospial, 10 Karahashi Rajomon-cho Minami-ku, Kyoto-shi, Kyoto, 601-8485, Japan.
²⁰ Department of Surgery, Kanazawa Nishi Hospital, 6-15-41 Ekinishihonmachi, Kanazawa-shi, Ishikawa, 920-0025, Japan.
²¹ Department of Surgery, Onishi Hospital, 139-1 Onishi, Fujika-shi, Gunma, 370-1401, Japan.
²² Department of Internal Medicine, Tsuruika Kyouritsu Hospotal, 9-34 Fumizono-cho, Tsuruoka-shi, Yamagata, 997-0816, Japan.
²³ Department of Gastroenterology and Hepatology, Japan Agricultural Cooperatives of Niigata Joetsu General Hospital, 148-1 Daidoufukuda, Joetsu-shi, Niigata, 943-8507, Japan.
²⁴ Department of Gastroenterology, Hirosaki Municipal Hospital, 1-8-3 Ohmachi, Hirosaki- shi, Aomori, 036-8004, Japan.
²⁵ Department of Gastroenterology, Social Insurance Shimonoseki Welfare Hospital, 3-3-8 Kamishinchi, Shimonoseki-shi, Yamaguchi, 750-0061, Japan.
²⁶ Department of Surgery, Tokatsu-clinic Hospital, 865-2 Hinokuchi, Matsudo-shi, Chiba, 271-0067, Japan.
²⁷ Department of Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi-shi, Gunma, 371-0014, Japan.
²⁸ Department of Neurology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara-shi, Tochigi, 329-2763, Japan.
²⁹ Department of Gastroenterology, Ako City Hospital, 1090 Nakahiro, Ako-shi, Hyogo, 678-0232, Japan.
³⁰ Department of HomeCareMedicine, Kameda Medical Center, 929 Higashicho, Kamogawa-shi, Chiba, 292-8601, Japan.
³¹ Department of Surgery, Fujiyoshida Municipal Hospital, 6530 Kamiyoshida, Fujiyoshida-shi, Yamanashi, 403-0005, Japan.
³² Department of Internal Medicine, Nara Prefectural Gojo Hospital, 5-2-59 Noharanishi, Gojo-shi, Nara, 637-8511, Japan.
³³ Department of Surgery, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, Oita, 874-0011, Japan.
³⁴ Director, Jomoto Gastroenteric & Internal Medical Clinic, 5-8-9 Kuhonnji, Kumamoto-shi, Kumamoto, 862-0976, Japan.
³⁵ Department of Cardiology and Vascular Surgery, Higashi-Washinomiya Hospital, 3-9-3 Sakurada, Kuki-shi, Saitama, 340-0203, Japan.
³⁶ Department of Gastro-enterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-Hondori Miyakojima-ku, Osaka-shi, Osaka, 534-0021, Japan.
³⁷ Department of Internal Medicine, Nishimino Kosei Hospital, 986 Oshikoshi, Yoro-gun Yoro-cho, Gifu, 503-1394, Japan.
³⁸ Department of Surgery, Ohtawara Red Cross Hospital, 2-7-3 Sumiyoshi-cho, Ohtawara-shi, Tochigi, 324-8686, Japan.
³⁹ Department of Internal medicine, Kohka Public Hospital, 3-39 Rokushin,Minakuchi-cho, Kohka-shi, Shiga, 528-0014, Japan.
⁴⁰ Department of Gastroenterology, Naganuma Municipal Hospital, 2-2-1 Chuo-minami,Naganuma-cho, Yubari-gun, Hokkaido, 069-1332, Japan.
⁴¹ Department of Internal Medicine, Murakami Memorial Hospital, 739 Oomachi, Saijo-shi, Ehime, 793-0030, Japan.
⁴² Endoscopy unit, Iwate prefectural central Hospital, 1-4-1 ueda, Morioka-shi, Iwate, 020-0066, Japan.
⁴³ Center for Gastroenterology, Sapporo Higashi-Tokushukai Hospital, 3-1 North33-East14,Higashi-ku, Sapporo-shi, Hokkaido, 065-0033, Japan.
⁴⁴ Internal Medicine, Matsue Seikyo General Hospital, 8-8-8 Nishitsuda, Matsue-shi, Shimane, 690-8522, Japan.
⁴⁵ Digestive Endoscopy Center, Sendai Kousei Hospital, 4-8 Hirose-machi,Aoba-ku, Sendai-shi, Miyagi, 980-0873, Japan.
⁴⁶ Department of Gastroenterology, Akita City Hospital, 4-30 Kawamotomatsuoka-cho, Akita-shi, Akita, 010-0933, Japan.
⁴⁷ Department of Surgery, Kure Kyosai Hospital, 2-3-28 Nishichuou, Kure-shi, Hiroshima, 737-8505, Japan.
⁴⁸ Department of Gastroenterology, Japan Red Cross Date General Hospital, 81 Suenaga, Date-shi, Hokkaido, 052-8511, Japan.
⁴⁹ Department of Surgery, Tsuchida Hospital, 2-11,South-21,West-9,Chuo-ku, Sapporo-shi, Hokkaido, 064-0921, Japan.
⁵⁰ Department of Gastroenterology, Hirano General Hospital, 176-5 Kurono, Gifu-shi, Gifu, 501-1192, Japan.
⁵¹ Department of Gastroenterology, Japanese Red Cross Society Shimizu Hospital, 2-2 minami,Shimizu-cho, Kamikawa-gun, Hokkaido, 089-0195, Japan.
⁵² Department of Gastroenterology, Higashi Sapporo Hospital, 3-3-7-35 Higashi-Sapporo,Shiroishi-ku, Sapporo-shi, Hokkaido, 003-8585, Japan.
⁵³ Department of Gastroenterology, Tachikawa General Hospital, 3-2-11 Kandamachi, Nagaoka-shi, Niigata, 940-8621, Japan.
⁵⁴ Department of Pediatric Surgery, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano-shi, Nagano, 380-8582, Japan.
⁵⁵ Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane-shi, Nagano, 399-4117, Japan.
⁵⁶ Department of Surgery, Hitachikoh Hospital, 3-4-22 Kujichou, Hitachi-shi, Ibaraki, 319-1222, Japan.
⁵⁷ Nutritional Therapy Center, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
⁵⁸ Department of Neurology, The Jikei University School of Medicine, Aoto Hospital, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan.

PMID: 27785173
PMCID: PMC5051036
DOI: 10.4021/gr392w

Abstract

Background: To examine the effects of percutaneous endoscopic gastrostomy (PEG) on quality of life (QOL) in patients with dementia.

Methods: We retrospectively included 53 Japanese community and tertiary hospitals to investigate the relationship between the newly developed PEG and consecutive dementia patients with swallowing difficulty between Jan 1st 2006 and Dec 31st 2008. We set improvements in 1) the level of independent living, 2) pneumonia, 3) peroral intake as outcome measures of QOL and explored the factors associated with these improvements.

Results: Till October 31st 2010, 1,353 patients with Alzheimer's dementia (33.1%), vascular dementia (61.7%), dementia with Lewy body disease (2.0%), Pick disease (0.6%) and others were followed-up for a median of 847 days (mean 805 ± 542 days). A total of 509 deaths were observed (mortality 59%) in full-followed patients. After multivariate adjustments, improvement in the level of independent living was observed in milder dementia, or those who can live independently with someone, compared with advanced dementia, characterized by those who need care by someone: Odds Ratio (OR), 3.90, 95% confidence interval (95%CI), 1.59 - 9.39, P = 0.003. Similarly, improvement of peroral intake was noticed in milder dementia: OR, 2.69, 95%CI, 1.17 - 6.17, P = 0.02. Such significant associations were not observed in improvement of pneumonia.

Conclusions: These results suggest that improvement of QOL after PEG insertion may be expected more in milder dementia than in advanced dementia.

Keywords: Alzheimer’s dementia; Cerebrovascular dementia; Percutaneous endoscopic gastrostomy; Quality of life; Risk factor.

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References

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The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia

Affiliations

The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia

Authors

Affiliations

Abstract

References

LinkOut - more resources

Full Text Sources

Research Materials