Survival Estimates for Patients with Abnormal Swallowing Studies

Cowen, Mark E.; Simpson, Sherry; Vettese, Theresa E.

doi:10.1007/s11606-006-5002-z

Cited by 48 publications

(30 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Overall, 119 patients in the dementia group and 129 patients in the nondementia group had dysphagia. We know that the literature supports a 50% death rate at 6 months in patients with end-stage dementia and dysphagia (17). Higaki's study had the diagnosis of dementia confirmed by the criteria of the Diagnostic and Statistical Manual of Mental Disorders (18).…”

Section: Recently Garrow Et Al Performed a Medline Search Viamentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in the Dementia Patient: Helpful or Hindering?

DeLegge¹

2008

Am J Gastroenterology

View full text Add to dashboard Cite

Percutaneous endoscopic gastrostomy (PEG) is a common technique performed worldwide. Recently, the use of PEG in the dementia patient with dysphagia for nutrition support has been called into question. Some reviews have reported no improvement in survival with PEG tubes in this population. Higaki and colleagues now present a large review of PEG tube placement in patients with dementia, which demonstrates a similar survival rate in patients without dementia receiving PEG tubes. The question of the utility of PEG tube placement for nutrition support in the dementia population requires an organized, prospective analysis to concretely answer the question.

show abstract

Section: Recently Garrow Et Al Performed a Medline Search Viamentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in the Dementia Patient: Helpful or Hindering?

DeLegge¹

2008

Am J Gastroenterology

View full text Add to dashboard Cite

show abstract

“…One group instituted a policy requiring PEG placement to wait until 30 days after hospital discharge, and 30-day mortality dropped from 51 percent to 15 percent (Abuksis et al 2004). Cowen, Simpson, and Vettese (1997) developed a model to predict survival based on several risk factors, including age, comorbidity, and baseline serum albumin. Predicted survival at 100 days varied from about 90 percent in the most favorable group to near 0 percent in the least favorable group.…”

Section: What Factors Predict Benefit In Tube Feeding?mentioning

confidence: 99%

Is Tube Feeding Futile in Advanced Dementia?

Lynch¹

2016

Linacre Q

View full text Add to dashboard Cite

It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding. However, presently available guidelines make a single recommendation against tube feeding for all patients. Clinicians, patients, and surrogates should be aware that the guidelines and prior commentary on this topic tend both to overestimate the strength of evidence for futility and to exaggerate the burdens of tube feeding. Shared decision making requires accurate information tailored to the individual patient's particular situation, not blanket guidelines based on flawed data. Lay Summary: Many doctors believe that tube feeding does not help people with advanced dementia. Scientific studies suggest that people with dementia who have feeding tubes do not live longer or gain weight compared with those who are carefully hand fed. However, these studies are not very helpful because of flaws in design, which are discussed in this article. Guidelines from professional societies make a blanket recommendation against feeding tubes for anyone with dementia, but an individual approach that takes each person's situation into account seems more appropriate. Patients and surrogates should be aware that the guidelines on this topic tend both to underestimate the benefit and exaggerate the burdens of tube feeding.

show abstract

“…Advanced age, low serum albumin, accompanying comorbidity, dementia or pulmonary aspiration (as the indication for PEG referral) and a documented abnormal swallow study, have all been recognised as independent risk factors which predict a poor outcome (Table 1). 5,6,10,13,[30][31][32][33] An effective strategy for PEG insertion?…”

Section: Indicators Of Poor Prognosis Following Peg Insertionmentioning

confidence: 99%

Percutaneous endoscopic gastrostomy: an effective strategy for gastrostomy feeding in patients with dementia

Sanders

Anderson

Bardhan³

2004

Clinical Medicine

View full text Add to dashboard Cite

-Percutaneous endoscopic gastrostomy (PEG) is an accepted technique for longterm enteral feeding. Its use has increased because of its simplicity and low complication rate. The demands for gastrostomy insertion have risen and now encompass indications where the long-term outcomes are uncertain. Dementia has become one of the commonest indications for gastrostomy feeding. This article reviews the justification for PEG feeding in dementia and suggests a practical approach for this difficult clinical situation. The clinical strategy described in this paper can be applied to other neurodegenerative diseases and provides a framework for improving a PEG service.

show abstract

Survival Estimates for Patients with Abnormal Swallowing Studies

Cited by 48 publications

References 40 publications

Percutaneous Endoscopic Gastrostomy in the Dementia Patient: Helpful or Hindering?

Percutaneous Endoscopic Gastrostomy in the Dementia Patient: Helpful or Hindering?

Is Tube Feeding Futile in Advanced Dementia?

Percutaneous endoscopic gastrostomy: an effective strategy for gastrostomy feeding in patients with dementia

Contact Info

Product

Resources

About