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Use of gastrostomy tubes in older Western Australians: a population‐based study of frequency, indications and outcomes
Author(s) -
Calver Janine,
McCaul Kieran A,
Burmas Melinda,
Horner Barbara J,
Flicker Leon
Publication year - 2009
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2009.tb02447.x
Subject(s) - medicine , population , gastrostomy tube , hazard ratio , gastrostomy , pediatrics , emergency medicine , surgery , environmental health , confidence interval
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.