Abstract
BackgroundThe physical status of patients who received enteral nutrition is still unclear. We aimed to compare the physical functional status among older adult patients who underwent percutaneous endoscopic gastrostomy (PEG) and those with nasogastric feeding.MethodsWe conducted a retrospective cohort study in an acute care hospital from August 1, 2009 to March 31, 2015. We included older adult patients (age ≥ 65 years) who were administered PEG or nasogastric feeding during hospitalization and received enteral nutrition for ≥14 days. We excluded patients who were completely bedridden at the administration of enteral nutrition. The primary outcome was death or becoming bedridden at discharge. The incidence of being bedridden among the patients who survived and received enteral nutrition at discharge was also compared according to the enteral nutrition method used.ResultsAmong the 181 patients who were administered enteral nutrition during hospitalization, 40 patients (22%) died and 66 patients (36%) were bedridden at discharge. The proportions of patients who fully resumed oral intake were 30% in the nasogastric group and 2.3% in the PEG group. The adjusted odds ratios comparing PEG feeding to nasogastric feeding were 0.38 (95% CI, 0.16–0.93) for death or being bedridden and 0.09 (95% CI, 0.02–0.40) for being bedridden among the patients who were receiving enteral nutrition at discharge.ConclusionsAmong older adult patients who were administered enteral nutrition, more than half of these patients died or became bedridden. PEG feeding could be associated with a lower risk of becoming bedridden or death in comparison with nasogastric feeding, although PEG feeding may be offered to the most mobile/ambulatory patients within clinical decision-making. Clinicians should carefully consider the administration and choice of enteral nutrition methods, when considering the prognosis of the patients.
Highlights
The physical status of patients who received enteral nutrition is still unclear
The medical measures for enteral nutrition, which involve the ingestion of formula into the intestinal tract via an enteral tube, primarily involve percutaneous endoscopic gastrostomy (PEG) and nasogastric tube feeding
We set a lower limit of the period of receiving enteral nutrition at 14 days in order to focus on patients who required long-term or permanent enteral nutrition, since the guidelines recommend PEG feeding for patients who are expected to receive enteral nutrition for longer than several weeks [5, 6]
Summary
The physical status of patients who received enteral nutrition is still unclear. We aimed to compare the physical functional status among older adult patients who underwent percutaneous endoscopic gastrostomy (PEG) and those with nasogastric feeding. The medical measures for enteral nutrition, which involve the ingestion of formula into the intestinal tract via an enteral tube, primarily involve percutaneous endoscopic gastrostomy (PEG) and nasogastric tube feeding. The guidelines recommend that PEG feeding is preferable to nasogastric feeding for the patients who are expected to receive enteral nutrition for longer than several weeks [5, 6]. In Japan, the survival rate of patients after receiving PEG feeding is higher than in Western countries [7,8,9]. Many family members feel that they do not have enough discussions on the choice of enteral feeding methods [11]
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