The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review

Leanne S Goldberg,1 Kenneth W Altman2 1Department of Otolaryngology, Mount Sinai School of Medicine, New York, NY, USA; 2Baylor College of Medicine, Houston, TX, USAPurpose: Over 4.5 million people in North America had a diagnosis of dementia in the year 2000, and more than half ha...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Goldberg LS, Altman KW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	dysphagia dementia PEG aspiration elderly feeding tube swallow Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/1d918a5e08ab42fab2449e96c17caed9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:1d918a5e08ab42fab2449e96c17caed9
record_format	dspace
spelling	oai:doaj.org-article:1d918a5e08ab42fab2449e96c17caed92021-12-02T03:13:56ZThe role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review1178-1998https://doaj.org/article/1d918a5e08ab42fab2449e96c17caed92014-10-01T00:00:00Zhttps://www.dovepress.com/the-role-of-gastrostomy-tube-placement-in-advanced-dementia-with-dysph-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Leanne S Goldberg,1 Kenneth W Altman2 1Department of Otolaryngology, Mount Sinai School of Medicine, New York, NY, USA; 2Baylor College of Medicine, Houston, TX, USAPurpose: Over 4.5 million people in North America had a diagnosis of dementia in the year 2000, and more than half had advanced disease with potential aspiration risk. There is much controversy regarding the use and timing of enteral feeding support in these patients with dysphagia. The management of dysphagia is far more complex when considering quality of life, “comfort care” hand feeding, the use of percutaneous endoscopic gastrostomy tube (PEG), and associated mortality rates. This study seeks to critically review the literature that evaluates PEG placement in this population. Methods: A systematic literature review of PubMed, from 1995–2012, was conducted to identify studies relating to PEG placement in dementia patients with dysphagia. The principal outcomes and related survival rates for this population were compared. Results: In total, 100 articles were identified in the search. Of these, ten met the search criteria and were analyzed. There was one study with a 2b level of evidence, one with 3b, and the remainder had level 4. All studies discussed long-term survival in the PEG versus non-PEG populations. No studies showed definitive evidence to suggest long-term survival rates improved in patients who underwent PEG placement as compared to those who did not. Two studies documented median survival worse in patients over age 80 with dementia and PEG placement.Conclusion: There is presently no evidence to suggest long-term survival rates improved in patients with advanced dementia who underwent PEG placement for dysphagia. Relevance to quality of life, need for nutrition and hydration, and ethical considerations in the decision process are discussed.Keywords: PEG, aspiration, elderly, feeding tube, swallowGoldberg LSAltman KWDove Medical PressarticledysphagiadementiaPEGaspirationelderlyfeeding tubeswallowGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1733-1739 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	dysphagia dementia PEG aspiration elderly feeding tube swallow Geriatrics RC952-954.6
spellingShingle	dysphagia dementia PEG aspiration elderly feeding tube swallow Geriatrics RC952-954.6 Goldberg LS Altman KW The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review
description	Leanne S Goldberg,1 Kenneth W Altman2 1Department of Otolaryngology, Mount Sinai School of Medicine, New York, NY, USA; 2Baylor College of Medicine, Houston, TX, USAPurpose: Over 4.5 million people in North America had a diagnosis of dementia in the year 2000, and more than half had advanced disease with potential aspiration risk. There is much controversy regarding the use and timing of enteral feeding support in these patients with dysphagia. The management of dysphagia is far more complex when considering quality of life, “comfort care” hand feeding, the use of percutaneous endoscopic gastrostomy tube (PEG), and associated mortality rates. This study seeks to critically review the literature that evaluates PEG placement in this population. Methods: A systematic literature review of PubMed, from 1995–2012, was conducted to identify studies relating to PEG placement in dementia patients with dysphagia. The principal outcomes and related survival rates for this population were compared. Results: In total, 100 articles were identified in the search. Of these, ten met the search criteria and were analyzed. There was one study with a 2b level of evidence, one with 3b, and the remainder had level 4. All studies discussed long-term survival in the PEG versus non-PEG populations. No studies showed definitive evidence to suggest long-term survival rates improved in patients who underwent PEG placement as compared to those who did not. Two studies documented median survival worse in patients over age 80 with dementia and PEG placement.Conclusion: There is presently no evidence to suggest long-term survival rates improved in patients with advanced dementia who underwent PEG placement for dysphagia. Relevance to quality of life, need for nutrition and hydration, and ethical considerations in the decision process are discussed.Keywords: PEG, aspiration, elderly, feeding tube, swallow
format	article
author	Goldberg LS Altman KW
author_facet	Goldberg LS Altman KW
author_sort	Goldberg LS
title	The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review
title_short	The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review
title_full	The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review
title_fullStr	The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review
title_full_unstemmed	The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review
title_sort	role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/1d918a5e08ab42fab2449e96c17caed9
work_keys_str_mv	AT goldbergls theroleofgastrostomytubeplacementinadvanceddementiawithdysphagiaacriticalreview AT altmankw theroleofgastrostomytubeplacementinadvanceddementiawithdysphagiaacriticalreview AT goldbergls roleofgastrostomytubeplacementinadvanceddementiawithdysphagiaacriticalreview AT altmankw roleofgastrostomytubeplacementinadvanceddementiawithdysphagiaacriticalreview
_version_	1718401839552004096

The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review

Ejemplares similares