Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy

Ma, Hull; Rawlings, J.; Murray, Frank; J, Field; As, McIntyre; Yr, Mahida; Hawkey, C. J.; Sp, Allison

doi:10.1016/0140-6736(93)93072-9

“…Complications occurred in a low percentage of the patients. The gastrointestinal complications were comparable to rates in other studies (Hull et al, 1993). In our study, no aspiration pneumonias occurred; other studies have shown a high incidence of aspiration pneumonia (Bordel-Marchasson et al, 1997); perhaps these differences are due to the good 10.5 AE 6.5 11.4 AE 8.5 11.6 AE 8.4* Circumference arm (cm) 22.8 AE 3.4 22.9 AE 9.4 26.7 AE 9* *P < 0.05, differences between first revision and third revisions.…”

Section: Discussionsupporting

confidence: 87%

Clinical and biochemical characteristics of patients with home enteral nutrition in an area of Spain

Luis

¹

,

Aller

²

,

Luis

³

et al. 2003

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Objective: The widespread use of long-term enteral nutrition and the substantive costs dictate a need to study outcome, clinical and epidemiological characteristics of these patients. The aim of our study was to analyze incidence, clinical and biochemical characteristics of a cohort of patients on home enteral nutrition (HEN). Design: Prospective observational study. Setting: Tertiary care. Subjects: Between January 1999 and December 2001, all adult patients living in Valladolid West area who were discharged from the hospital on HEN were prospectively studied and followed up. Interventions: Information for each patients was prospectively recorded by the dietitian of the team, and include age, sex, body mass index, tricipital skinfold, midarm circumference, underlying disease, exitus, dates of initiation and discontinuation of HEN, nutrient formula, mode of administration and complications of HEN. During HEN, physicians supervised the home patients and the patients themselves or their close relative were asked to contact our nutrition team if any problem occurred. Finally the yearly incidence of HEN was calculated each year on the basis of the estimated population in our area of recruitment, assuming almost all HEN patients were reported. Results: In 1999, the incidence of HEN in our area was patients 15 per 100 000 inhabitants. This incidence rate rose to 21.3 in 2000 and decreased to 9.52 in 2001. The mean age of all patients was 58.7 AE 13 y. The distribution of patients by diseases was: 71 (69.6%) had a head and neck cancer; 14 (13.7%) had a neurological disorder affecting swallowing (cerebrovacular accident and/or dementia); 6 (5.9%) had tumors in different locations with anorexia; and 11 (10.8%) had one of several miscellaneous diseases inducing dysphagia or anorexia. HEN was administered orally in 81 patients (79.4%), via a nasogastric tube (NGT) in 15 patients (14.7%), via a percutaneous gastrostomy (PEG) in five patients (4.9%), and via a jejunostomy in one patient (1%). The mean duration of HEN was 101 AE 46.9 days. During the course of HEN, six patients had diarrhea (5.9%), and four (3.9%) constipation, and two vomiting (2%) that did not require cessation of HEN. Albumin, prealbumin, transferrin and lymphocytes improved in all the groups, when comparing the first review with the last. After the follow-up (3 y) with review, each 3 months, 10 of the 102 patients (9.8%) had died, and 92 (90.2%) were alive. Survival probability was influenced by the access route, with the worse outcome in patients with no oral nutrition (NGT, PEG and jejunonostomy; hazard ratio: 24.9; 95% CI: 4.1 -52), adjusted by age, sex and diagnosis. Conclusions: In conclusion, HEN is a valid and safe technique for nutrition support, with a good clinical outcome in our area.

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“…The gastrointestinal complications were comparable to rates in other studies (Hull et al, 1993). In our study, no aspiration pneumonias occurred, others studies showed a high incidence of aspiration pneumonia (Bordel-Marchasson et al, 1997;Nehra et al, 1999), perhaps these differences are due to the good consciousness and ability to perform and comprehend daily activities of our patients with a low average age and the low rate of neurological disorders (less than 10%) in our study.…”

Section: Discussionsupporting

confidence: 72%

Experience of 6 years with home enteral nutrition in an area of Spain

Luis

¹

,

Aller

²

,

Izaola

³

et al. 2005

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Objective: The wide spread use of long-term enteral nutrition and the substantive costs dictate a need to study outcome, clinical and epidemiological characteristics of these patients. The aim of our study was to analyze incidence and characteristics of a cohort of patients on HEN during 6 years, after our previous pilot study of 3 years. Design: Prospective observational study. Setting: Tertiary care. Subjects: Between January 1999 and December 2004, all adult patients living in Valladolid West area who were discharged from the hospital on HEN were prospectively studied and followed up. Interventions: Information for each patient was prospectively recorded by the dietitian of the team, and include age, sex, body mass index, tricipital skinfold, midarm circumference, underlying disease, exitus, dates of initiation and discontinuation of HEN, nutrient formula, mode of administration and complications of HEN. During HEN, physicians supervised the home patients and the patients themselves or their close relative, were asked to contact our nutrition team if any problem occurred. Finally the yearly incidence of HEN was calculated each year on the basis of the estimated population in our area of recruitment, assuming almost all HEN patients were reported.

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“…After hemispheric stroke, neuroplasticity promotes an adaptation and allows the control of the muscles of swallowing, it is reorganized in the hemisphere not affected 14 . Other studies also reported the recovery of dysphagia months or years after a stroke, but the recovery rate remained low 23,24 .…”

Section: Discussionmentioning

confidence: 99%

Efetividade da intervenção fonoaudiológica na progressão da alimentação via oral em pacientes com disfagia orofaríngea pós AVE

Inaoka¹,

Albuquerque

²

2014

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Objetivo : analisar a efetividade na progressão da alimentação via oral de pacientes com sintomas de disfagia, que sofreram acidente vascular encefálico prévio ou atual, internados em um hospital federal do Rio de Janeiro.Métodos : foi feito estudo retrospectivo do prontuário de 20 pacientes com acidente vascular encefálico, para os quais foi solicitada fonoterapia para disfagia. Para comparação do nível de ingestão oral de cada paciente, antes e depois da terapia, foi utilizada uma escala funcional. Foram estudados os possíveis fatores de interferência na progressão na escala como: idade, intercorrências clínicas, tempo e incidência prévia do AVE. Os seguintes indicadores de resultado foram analisados: tempo para retirada de via alternativa de alimentação e tempo para reintrodução de alimentação via oral.Resultados : dos 20 pacientes, 15 apresentaram melhora na escala de ingestão oral após a fonoterapia. As intercorrências clínicas foram consideradas estatisticamente significantes para a não evolução da alimentação via oral. Os outros fatores analisados não demonstraram significância estatística, sugerindo não interferir na melhora ou piora do paciente. Foi possível reintroduzir alimentação via oral e retirar via alternativa de alimentação antes de 10 dias.Conclusão : a fonoterapia é efetiva para melhorar a ingestão de alimentos por via oral nos pacientes com AVE e disfagia neurogênica, atendidos em ambiente hospitalar, salvo se apresentarem intercorrências clínicas e rebaixamento do nível de consciência durante o processo.

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Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy

Cited by 220 publications

References 14 publications

Clinical and biochemical characteristics of patients with home enteral nutrition in an area of Spain

Clinical and biochemical characteristics of patients with home enteral nutrition in an area of Spain

Experience of 6 years with home enteral nutrition in an area of Spain

Efetividade da intervenção fonoaudiológica na progressão da alimentação via oral em pacientes com disfagia orofaríngea pós AVE

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