Complications of jejunostomy tube feeding in nursing facility patients

Maintaining nutrition in patients who are unable to eat is difficult. Jenunostomy feeding has been recommended, especially for patients known to aspirate, but few data are available regarding its efficacy in the nursing home setting. We performed a retrospective review of 44 consecutive jejunostomy fed patients in a skilled nursing facility (SNF) to determine the incidence of complications, particularly aspiration pneumonia. Among them, 81.8% experienced at least one complication, most frequently tube dislodgement or obstruction. In 52.2%, intervention by the physician was required before feeding could be resumed. The incidence of aspiration pneumonia was 15.9%: 31.6% in patients who had previously aspirated and 4% in those without previous aspiration (p less than 0.05). We conclude that jejunostomy feeding does not protect against aspiration pneumonia in patients known to aspirate, and that the high overall complication rate makes its use problematic in the SNF setting.