Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes

Abstract

Objective: to compare four types of long term tube feeding regarding nutritional effects, tube-related complications and outcome. Methods: retrospective study. Results: Mean BMI at time of tube insertion is 23.3, two years later 20.3 (P= 0.0312). Patients have follow up with HHC their mean BMI at base line is 23.5, after two years 21.53 (p =0.547). No difference regarding albumin, urea, sodium, potassium, hemoglobin over 6, 12, 24 months either patient has followed up with HHC or not. High creatinine level in 12 months with jejunostomy tube (p= 0.0270). There are no major complications among the patients. No minor complications within 48 h of tube insertion in 42.18%, No complications after 48 h of tube insertion in 36.05%.The mortality rate is 56.59%. Old age is associated with a higher mortality (p 0.0018) and survival is better for patients who have HHC follow up (p <0.0001).The commonest cause of death is aspiration pneumonia with septic shock and respiratory failure 37.68 % and PFG has the highest mortality rate. Conclusion: 1) Patients on long-term feeding tubes don’t gain weight. There is an urgent need to improve method of nutritional assessment and to have regular follow up to calculate their calories requirement and adjust their formula accordingly; 2) The nutritional status in four feeding tubes is similar except in12 months there is significant difference in creatinine in jejunostomy tube; 3) Rate of complications is low among our patients with reference to the long period of follow-up. Almost all complications have been mild and could be managed throughout adequately; 4) Tube related infection and leakage reported more in PFG. It could be because it is the commonest tube used among our patients.