Patient selection for pediatric gastrostomy tubes: Are we placing tubes that are not being used?
Topic overview
Study of 142 pediatric inpatient gastrostomy tube placements found 15% were used less than 6 months, particularly in adolescents and traumatic brain injury patients. One-third of short-term cases required costly fistula closure operations, suggesting nasogastric tubes may be more appropriate for these populations.
Key takeaways
- 15% of pediatric inpatient gastrostomy tubes were used for less than 6 months, suggesting overutilization in select populations.
- Adolescents (≥12 years) and traumatic brain injury patients had significantly higher rates of short-term GT use and early discontinuation.
- One-third of patients with short-term GTs required surgical gastrocutaneous fistula closure, adding morbidity and cost (~$30K per patient).
- Consider nasogastric tube feeding as an alternative to surgical GT placement in adolescents and TBI patients with uncertain long-term needs.
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