Failure to Thrive, Oral Intake, and Inpatient Status Prior to Gastrostomy Tube Placement in the First Year of Life is Associated with Persistent Use 1-year Later
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Mar 2022 · 1 min read
In brief
In brief
Retrospective study of 140 infants undergoing gastrostomy tube placement identifies key predictors of persistent tube dependence at one year: failure to thrive diagnosis, inpatient status at surgery, and minimal oral intake pre-operatively significantly increase odds of continued GT use, informing patient selection for surgical intervention.
Written by the GCMD Library team from the article.
Background
: Gastrostomy tube (GT) placement is a common procedure in infants (≤1-year-old). There is variation in patient selection and a paucity of studies examining which patients require long-term enteral access. The objective of this study was to assess demographic and clinical factors associated with persistent GT use (PGU) at 1-year after placement.
Methods
: We performed a single-institution retrospective review of patients ≤1-year-old who underwent GT placement from January 31, 2014, and January 31, 2020, using institutional NSQIP-P data supplemented with chart review. Multivariable logistic regression analysis was performed to identify factors associated with PGU. Clinical predictors were selected a priori, and a p-value less than 0.05 was used to detect a significant association.
Results
: 140 patients were included, and 118 had a 1-year follow-up. At 1-year following GT placement, 38 patients had weaned from their GT (32.2%). Failure to thrive (FTT), and inpatient admission prior to surgery are associated with increased odds of PGU a
t 1-year after surgery, OR
: 5.19 and 6.02 respectively. There is an inverse association between the percentage of feeds taken by mouth at the time of surgery and the odds of PGU at 1-year (OR: 0.03).
Conclusion
: Patients who have FTT (documented prior to surgery) or an inpatient admission prior to GT had a higher odds of PGU at 1-year post-op. Additionally, the amount taken by mouth at the time of GT placement was inversely related to PGU. These factors are important in determining the need for a surgical gastrostomy tube.
Level of evidence
: II