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Use of gastrostomy tubes in older Western Australians: a population-based study of frequency, indications and outcomes.
Med J Aust. 2009 Apr 6;190(7):358-61
Authors: Calver J, McCaul KA, Burmas M, Horner BJ, Flicker L
OBJECTIVE: To determine the number of older Western Australians who had a gastrostomy tube (GT) placement from 1994 to 2004, to describe their characteristics, and to examine outcomes after GT placement, including rehospitalisation for complications and survival. DESIGN AND DATA SOURCES: Secondary analysis of hospital (inpatient) data and linked mortality data from the WA Data Linkage System. MAIN OUTCOME MEASURES: Patient characteristics (age, sex and morbidity profile); numbers of GT closures, replacements and complications within 1 year of GT placement; age- and sex-specific survival outcomes calculated at 7, 30, 60 and 180 days, and 1 and 3 years; and mortality hazard ratios calculated for six conditions of interest, identified using all available diagnosis information on the inpatient record. RESULTS: In Western Australia, 2023 people aged 65 years or older underwent a GT placement for the first time during the period 1994-2004, half of whom had a known history of cerebrovascular disease (50.3%). Rehospitalisation within 1 year for a GT replacement procedure, mechanical complications and incident pneumonitis occurred in 13%, 4% and 9% of patients, respectively. More than half of the patients who underwent a GT placement died within 1 year. Survival outcomes were poorest for patients with motor neurone disease and metastatic cancer. CONCLUSION: To better understand this complex area of health care, questions regarding decision making -- by patients, families, physicians, hospitals and other caring organisations -- about GT placement and maintenance need to be addressed.
PMID: 19351308 [PubMed - indexed for MEDLINE]