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Long-term percutaneous endoscopic gastrostomy feeding in young adults with multiple disabilities

L Lee1, M MacPherson

  • 1Department of Rehabilitation Medicine, Concord Hospital, Sydney, New South Wales 2139, Australia.

Internal Medicine Journal
|October 24, 2009
PubMed

Insights

Percutaneous endoscopic gastrostomy (PEG) feeding in young adults with profound multiple disabilities offers extended survival but little improvement in quality of life. Complications are common, requiring significant nursing care.

Area of Science:

  • Neurology
  • Gastroenterology
  • Disability Studies

Background:

  • Young adults with profound multiple disabilities often face challenges with nutrition and respiratory health.
  • Percutaneous endoscopic gastrostomy (PEG) feeding is a common intervention for these individuals.

Purpose of the Study:

  • To evaluate the outcomes of initiating PEG feeding in young individuals with severe intellectual disability and quadriplegia.
  • To assess the long-term impact of PEG feeding on quality of life and medical stability.

Main Methods:

  • A retrospective audit of 40 adults (15-40 years) with lifelong intellectual disability and quadriplegia who received PEG feeding between 1990-2008.
  • Data collected on reasons for PEG insertion, complications, survival, cognitive function, medication use, and nursing interventions.

Main Results:

  • Reasons for PEG feeding included undernutrition and recurrent aspiration. Patients lived an average of 8.5 years with PEG feeding (up to 18 years).
  • All patients experienced PEG-related complications. No improvements in cognition or medication reduction were observed. Frequent nursing interventions were required.
  • Ten deaths occurred during the review period, primarily due to pneumonia secondary to neurological deterioration.

Conclusions:

  • PEG feeding can prolong life for young adults with profound multiple disabilities.
  • Despite extended survival, PEG feeding offers minimal gains in quality of life and is associated with significant complications and care needs.
Abstract

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