TITLE

IMPACT OF IMPLEMENTATION OF SPECIFIC FEEDING GUIDELINES ON THE 30 DAY MORTALITY AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG TUBE INSERTION) IN HOSPITALISED PATIENTS

AUTHOR(S)
Mohammed, F.; Gasem, J.; Balakrishnan, S.; Hurst, S.; Conlong, P.; Rameh, B.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA97
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: A previous audit at the Royal Oldham Hospital done between March 1999 and June 2000 had shown that there was a 42% mortality at 30 days after PEG tube insertion in hospitalised patients. Several recommendations were made after this audit: patient's head to be kept at an angle of 30-45 degrees when feeding; recheck gastric contents before feeds (if greater than 150 mis residue aspirated then withhold feeds); and use of a gastroenterology specialist nurse to assess patients before and after PEG tube insertion. Our aim was to determine whether these measures led to a reduction in 30 day mortality in hospitalised patients. Methods: Reviewed the medical records of hospitalised patients who underwent PEG insertion between June 2000 and December 2001. Cause of death was identified from clinical notes and death certificates for patients who died within 30 days of PEG insertion. Results: 73 PEG tubes were inserted during the audit period. 73% of patients were more than 70 years of age (range 38-98). 51 patients (70%) had PEG tubes because of dysphagia secondary to a cerebrovascular accident. 58 patients (80%) had their PEG tubes inserted within one week of referral and 5 patients had insertion delayed because of the need for further assessment prior to PEG insertion. There were no immediate deaths during or within 24 hours of the procedure but there were 16 deaths (22%) within 30 days and 9 (12%) of these were PEG related. There was a statistically significant difference (p < 0.05) in mortality compared to the previous audit period. Conclusions: Careful assessment of patients before and after PEG tube insertion and implementation of specific feeding guidelines can decrease the 30 day mortality after PEG tube insertion.
ACCESSION #
9747945

 

Related Articles

  • Early Versus Delayed Feeding After Placement of a Percutaneous Endoscopic Gastrostomy: A Meta-Analysis. Bechtold, Matthew L.; Matteson, Michelle L.; Choudhary, Abhishek; Puli, Srinivas R.; Jiang, Peter P.; Roy, Praveen K. // American Journal of Gastroenterology;Nov2008, Vol. 103 Issue 11, p2919 

    BACKGROUND: Traditionally, tube feedings have been delayed after percutaneous endoscopic gastrostomy (PEG) placement to the next day and up to 24 h postprocedure. However, results from various randomized controlled trials (RCTs) indicate earlier feeding may be an option. We conducted a...

  • Emergency department visits by demented patients with malfunctioning feeding tubes. Odom, S.R.; Barone, J.E.; Docimo, S.; Bull, S.M.; Jorgensson, D. // Surgical Endoscopy;Apr2003, Vol. 17 Issue 4, p651 

    Background: Objective data indicate that feeding tubes in demented patients may not be efficacious and can have serious complications, but no study characterizes emergency department resource utilization for these patients. This study aimed to evaluate the incidence and resource utilization...

  • Teaching for discharge: Gastronomy tubes. Alltop, Shirley Ann; Sarsany, Sandy L. // RN;Nov88, Vol. 51 Issue 11, p42 

    Discusses the techniques in teaching patients how to manage a gastrostomy tube on their own. Review of basic information about gastrostomy tubes; Procedures for self-care skills; Treatment of potential problems in managing a gastrostomy tube.

  • Managing home enteral tube feeding for children. Khair, Jamil // British Journal of Community Nursing;Mar2003, Vol. 8 Issue 3, p116 

    Discusses the management of home enteral tube feeding for children. Various routes of enteral tube feeding; Three basic methods for feeding through an enteral tube; Problem solving in nasogastric, gastrostomy and jejunostomy feeding; Potential problem associated with enteral tube feeding.

  • Laparoscopic Roux-en-Y Feeding Jejunostomy: A New Minimally Invasive Surgical Procedure for Permanent Feeding Access in Children with Gastric Dysfunction. Neuman, Heather B.; Phillips, J. Duncan // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb2005, Vol. 15 Issue 1, p71 

    Long-term feeding access in children with foregut dysfunction has traditionally been achieved by gastrostomy tube placement with or without fundoplication. Alternatives after failed procedures have included re-do fundoplication, transpyloric gastrojejunal tube placement, loop jejunostomy (open...

  • Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. Park, R.H.R.; Allison, M.C.; Lang, J.; Spence, E.; Morris, A.J.; Danesh, B.J.Z.; Russell, R.I.; Mills, P.R. // BMJ: British Medical Journal (International Edition);5/30/92, Vol. 304 Issue 6839, p1406 

    Compares percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with neurological dysphagia in Glasgow, Scotland. Occurrence of treatment failure in nasogastric patients; Mean duration of feeding for the nasogastric group; Effectiveness of percutaneous endoscopic...

  • Nutrition in advanced dementia. Sherman, Fredrick T. // Geriatrics;Nov2003, Vol. 58 Issue 11, p10 

    Editorial. Describes the benefits and limitations of hand- and tube-feeding in demented older patients. Effectiveness of chronic percutaneous endoscopic gastrostomy-feeding in preventing aspiration, prolong life, prevent suffering and improve the quality of life for patients with dementia;...

  • Gastrostomy tube feeding: when to start, what to feed and how to stop. Gottrand, F.; Sullivan, P. B. // European Journal of Clinical Nutrition;May2010 Supplement, Vol. 64, pS17 

    The article presents information on features and usage of feeding through Gastrostomy tube. It informs that chronic diseases of childhood can be helped by undernutrition. It states that the enteral tube feeds are helpful in gastrointestinal tracts. It is stated that transpyloric feeding is...

  • Blocked percutaneous endoscopic gastrostomy tube - an unusual cause. Joshi, Vijay; Banerjee, Ashis // British Journal of Medical Practitioners;2009, Vol. 2 Issue 2, p46 

    The article presents a case study of an 82-year-old woman who was undergoing a percutaneous endoscopic gastrostomy (PEG) feeding and had suffered from strokes in the past. She was admitted in a nursing home and had episodes of vomiting and choking following PEG feeding. Since the patient's first...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics