Temporary feeding tube dependency in pediatric patients: A retrospective analysis of risk factors and preventative practices

Abstract

Prolonged temporary tube feeding places pediatric patients at risk of tube dependency. This chart audit aimed to identify current temporary tube feeding practice within an Australian tertiary hospital, risk factors of prolonged temporary tube feeding, and the likelihood of high risk patients receiving tube dependency preventative practices. A retrospective chart audit was conducted of the medical records of 187 pediatric inpatients who had temporary feeding tubes placed in an Australian tertiary hospital between November 2014 and March 2017. Information was collected on patient demographics and tube feeding practices. The Kaplan Meier estimate, Cox regression and logistic regression were used to determine the median time until feeding tube removal, predictors of prolonged temporary tube feeding, and the relationship between these predictors and utilization of preventative practices. The Kaplan Meier estimate of median tube feeding duration was 6.43 months (95% CI: 5.17-7.90). Predictors of prolonged tube feeding were prematurity (p=0.003), feeding difficulties requiring speech pathology referral (p=0.002), and referral for long-term feeding tubes (p=0.002). There was a low prevalence of preventative clinical practices including documentation of tube exit plans (5.3%, n=10) and referral for long-term feeding tubes (27.3%, n=51). Exhibiting risk factors for prolonged tube feeding did not increase the likelihood of receiving preventative clinical practices. The prolonged duration of temporary tube feeding within this sample highlights the need for improved utilization of tube dependency preventative practices within high risk groups.