Feeding gastrostomy: a reappraisal

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Oncology

Background:

• Feeding gastrostomy is utilized for nutritional support in patients unable to maintain adequate oral intake.
• The long-term benefits and risks, particularly in specific patient populations, require further elucidation.

Purpose of the Study:

• To evaluate the outcomes of feeding gastrostomy in patients requiring nutritional support.
• To determine the impact of patient's neurological status (coma) on the efficacy and survival after gastrostomy.

Main Methods:

• A retrospective review of 67 patients who underwent feeding gastrostomy over a ten-year period.
• Analysis of 30-day mortality rates and long-term survival based on pre-procedure neurological status and underlying diagnosis.

Main Results:

• The overall 30-day mortality rate was 30%.
• Patients with head and neck carcinoma or those not in a coma experienced extended useful survival.
• Comatose patients had similar mortality but did not regain consciousness, with some surviving over a year.

Conclusions:

• Feeding gastrostomy in comatose patients is of questionable benefit and unlikely to improve patient outcomes.
• The primary rationale for gastrostomy in comatose individuals appears to be for nursing care facilitation and transfer to chronic care facilities.