Evolving Trends of Gastrostomy Insertion Within a Pediatric Population

Area of Science:

• Pediatric Gastroenterology
• Clinical Epidemiology
• Public Health

Background:

• Gastrostomy insertion is vital for children with complex needs and severe disabilities.
• Increasing accessibility and acceptance contrast with a lack of population-based occurrence data.
• Limited understanding exists regarding gastrostomy use in specific pediatric clinical subgroups.

Purpose of the Study:

• To investigate trends in first gastrostomy insertion within a pediatric population.
• To analyze age and birth cohort patterns of gastrostomy use over a 32-year period.
• To identify indications and clinical subgroups for gastrostomy insertion.

Main Methods:

• A birth cohort study utilizing linked administrative and health data from Western Australia (1983-2014).
• Analysis of 690,688 children born between 1983 and 2009.
• Identification and classification of gastrostomy indications using diagnosis codes from hospitalization data.

Main Results:

• A total of 466 gastrostomies were performed, with an overall prevalence of approximately 7 per 10,000 births.
• Increasing trends in gastrostomy insertions were observed in preschool-aged children over calendar years and across successive birth cohorts.
• Neurological disorders were the primary indication (79.8%), frequently comorbid with intellectual disability (87.4% of neurological cases).

Conclusions:

• Gastrostomy insertion for children requiring long-term enteral feeding support has increased.
• The procedure is predominantly performed for severe neurological disabilities, including intellectual disability.
• Gastrostomy offers families a viable option for long-term home-based management of feeding difficulties.