Nationwide Prevalence and Outcomes of Long-Term Nasogastric Tube Placement in Adults

Abstract

Tube feeding (TF) is commonly used for patients with severe swallowing disturbance, and patients with chronic dysphagia are often provided with a long-term nasogastric tube (NGT). However, nationwide epidemiological data on long-term NGT placement are limited. The present study identified the prevalence and outcomes of patients with long-term NGT placement in Taiwan. Data were obtained from the Longitudinal Health Insurance Database. Patients with NGT placement for more than 3 months between 2000 and 2012 were enrolled in this cohort study. An NGT cohort of 2754 patients was compared with 11,016 controls matched for age, sex, residential area, and comorbidities. The prevalence rate of long-term NGT reached 0.063% in 2005 and then remained stable at 0.05–0.06%. The major causes of NGT placement were stroke (44%), cancer (16%), head injury (14%), and dementia (12%). Men (63%) were more likely to have long-term NGT placement than women (37%). The adjusted hazard ratios were 28.1 (95% CI = 26.0, 30.3) for acute and chronic respiratory infections; 26.8 (95% CI = 24.1, 29.8) for pneumonia, 8.84 (95% CI = 7.87, 9.93) for diseases of the esophagus, stomach, and duodenum; and 7.5 (95% CI = 14.7, 20.8) for mortality. Patients with NGT placement for more than 6 months had a higher odds ratio (1.58, 95% CI = 1.13, 2.20) of pneumonia than those with NGT placement for less than 6 months. Only 13% and 0.62% of the patients underwent rehabilitation therapy and percutaneous endoscopic gastrostomy, respectively. Long-term NGT use was associated with a higher risk of comorbidities and mortality. Stroke was the main illness contributing to long-term NGT use. Further interventions are necessary to improve the negative effects of long-term TF.

Evolving Therapeutic Roles of Nasogastric Tubes: Current Concepts in Clinical Practice

“…There is a dearth of epidemiological data for use of long-term NGT. A study in Taiwan done by Chung Hsu et al [ 45 ] showed that long-term NGT placement was associated with higher risk of mortality and comorbidities such as acute and chronic respiratory illnesses, especially in stroke patients. In acute stroke patients, it is common to use a NGT as the patients often have decreased consciousness and related dysphagia.…”

Predictors for Failed Removal of Nasogastric Tube in Patients With Brain Insult

“…NGT feeding may suffice for patients requiring nutritional support for up to 4 weeks [5]. Extended utilization of an NGT can lead to various adverse events, such as nasal wing lesions, chronic sinusitis, gastroesophageal reflux, gastrointestinal bleeding, and aspiration pneumonia [6][7][8]. Therefore, for extended periods, the placement of a gastrostomy tube should be taken into consideration to avoid the side effects of long-term usage of NGT for nutrition supply [5].…”

Enteral Delivery of Pravastatin Sodium Tablets: Effect of Compounding into a Liquid Form and Co-Administration of Enteral Nutrition

“…This approach should enable the evaluation of the effectiveness of drug administration (the effective amount of drug administered), also pinpointing whether any concerns arise from the compounding process or the administration procedure. Pravastatin sodium was selected as the model drug because it is a widely prescribed medication for the elderly population (enteral tube feeding being more prevalent among the elderly [19,20]), and is exclusively available in Italy in tablet form [21]. Furthermore, our interest extended to understanding the potential influences that nutritional formulas could exert on the amount of drug reaching the gastroenteric tract, as an interaction leading to dose reduction cannot be ruled out a priori [9].…”