Factors associated with mechanical device-related complications in tube fed patients: A multicenter prospective cohort study.

Fernanda Raphael Escobar Gimenes,Camila Baungartner Travisani,Flávia Fernanda Luchetti Rodrigues Baracioli,Soraia Assad Nasbine Rabeh,Patricia Rezende Do Prado,Adriane Pinto De Medeiros,Fabiana Bolela De Souza,Marta Cristiane Alves Pereira,Janine Koepp,Adriana Inocenti Miasso,Chun Chieh Yeh

doi:10.1371/journal.pone.0241849

Fernanda Raphael Escobar Gimenes, Camila Baungartner Travisani + Show 9 more

Open Access

https://doi.org/10.1371/journal.pone.0241849

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Journal: PloS one	Publication Date: Nov 19, 2020
Citations: 9	License type: CC BY 4.0

Abstract

To identify the types of nasogastric/nasoenteric tube (NGT/NET)-related adverse events and to analyze the degree of harm and the factors associated with mechanical device-related complications. A prospective cohort study was conducted from October 2017 to April 2019 in seven Brazilian hospitals. Data from 447 adult patients with NGT/NET were collected through electronic forms. Three methods were used to assess the NGT/NET-related adverse events: (1) encouraging spontaneous reports; (2) regular visits to the wards; and (3) review of medical records. The events were classified as mechanical device-related complications and other events. The degree of harm was classified according to the World Health Organization's International Classification for Patient Safety. Data were analyzed using the R program, version 3.5.3. The following tests were applied to identify associations between the explanatory and response variables: Cochran-Armitage Chi-Square test, Fisher's exact test, and Linear-by-linear Chi-Square test. Logistic regression analysis was performed to verify the predictors of mechanical device-related complications. All analyses were performed considering a 5% significance level. 191 NGT/NET-related adverse events were identified in 116 patients; the majority were mechanical device-related complications and resulted in mild harm to the patient. At the moment of the event, patients had a mean of 3.27 comorbidities, were highly dependent on nursing care, with high risk of death and altered level of consciousness. There was no association between the degree of harm and the care complexity, disease severity or level of consciousness. Intensive care was the strongest predictor for mechanical device-related complications and critical patients had a four times greater likelihood of presenting this type of event when compared to patients receiving minimal care. Intensive care patients should receive special attention as the complexity of care is an important predictor for mechanical device-related complications in tube fed patients.

Highlights

Feeding tubes are common in acute and chronic care settings for the delivery of enteral nutrition and/or medications to patients of all ages [1]
NGT/NET-related adverse events were identified in 116 patients; the majority were mechanical device-related complications and resulted in mild harm to the patient
At the moment of the event, patients had a mean of 3.27 comorbidities, were highly dependent on nursing care, with high risk of death and altered level of consciousness

Summary

Introduction

Feeding tubes are common in acute and chronic care settings for the delivery of enteral nutrition and/or medications to patients of all ages [1]. 51 reports of pneumothorax following feeding tube placement were reported from January 2012 to July 2017 in the U.S.A. In most cases, there was a need for urgent intervention, including decompression with a needle or insertion of a chest drain. There was a need for urgent intervention, including decompression with a needle or insertion of a chest drain Some of these events were associated with cardiac arrest and death [5]

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