Does Feeding Tube Insertion and Its Timing Improve Survival?

• Autores: Joan M. Teno, Pedro L. Gozalo, Susan L. Mitchell, Sylvia K. Kuo, Ramona L. Rhodes, Julie P. W. Bynum, Vincent Mor
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 60, Nº. 10, 2012, págs. 1918-1921
• Idioma: inglés
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• Dialnet Métricas: 1 Cita
• Resumen

  • 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.