Gastrostomies in older patients: the 1990 National Hospital Discharge Survey

Although many published case series have described patients' experiences after gastrostomy placement, generalizing from the results of case series can present problems. The purpose of this study was to examine gastrostomy placement among hospitalized older patients in a nationally representative sample.

Using the 1990 National Hospital Discharge Survey, age, sex, race, primary and secondary diagnoses, and mortality were described for hospitalized patients aged 65 years and older having gastrostomies. Age-specific placement rates were calculated using mid-1990 Census Bureau population estimates.

In 1990 an estimated 85,400 patients aged 65 years and older were discharged from hospitals with gastrostomies. Frequent primary diagnoses included cerebrovascular disease (19 percent), pneumonia with or without aspiration (12 percent), neoplasm (11 percent), and fluid and electrolyte disorders (9 percent). The in-hospital mortality rate was 16 percent. Age-specific rates for gastrostomy increased from 1.2 per 1000 for those aged 65 to 74 years to 10.8 per 1000 for those aged 85 years and older.

In 1990 older hospitalized patients had gastrostomies with surprising frequency, and their in-hospital mortality rate was substantial. An estimated 1 percent of the US population aged 85 years and older was discharged from a hospital in 1990 with a gastrostomy.