Document Detail


Does artificial enteral nutrition prolong the survival of institutionalized elders with chewing and swallowing problems?
MedLine Citation:
PMID:  9597053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is a lack of prognostic data regarding tube feeding of institutionalized elderly people. The objective of this study was to determine the impact of feeding tubes on the survival of nursing home residents with chewing and swallowing problems, and to follow the course of the tube-fed residents over one year. METHODS: We conducted a cohort study with 12-month follow-up using Minimum Data Set resident assessments from 1991. Participants included 5,266 nursing home residents over the age of 65 with chewing and swallowing problems living in 272 Washington state nursing homes. Residents who had a feeding tube were identified. Baseline clinical characteristics and 12-month survival were compared for residents with and without feeding tubes. The proportion of tube-fed residents who became tube-free during the follow-up period was determined, and clinical features that predicted this outcome were examined. RESULTS: Among the residents with chewing and swallowing problems, 10.5% had a feeding tube. After adjusting for potential confounding covariates, tube-fed residents had a significantly higher one-year mortality rate than those without feeding tubes (risk ratio, 1.44; 95% CI, 1.17-1.76). Of the 430 residents with feeding tubes who survived the follow-up period, 25.1% became free of a feeding tube. Age less than 87 years was associated with a significantly greater likelihood of becoming tube-free (odds ratio, 1.66; 95% CI, 1.03-2.6). CONCLUSIONS: Residents selected for feeding tube placement have poorer survival after one year than residents who are not tube-fed. However, the feeding tubes are removed in a significant proportion of residents who survive one year. Residents with a potentially reversible condition, for whom the feeding tubes are a temporary intervention, need to be identified.
Authors:
S L Mitchell; D K Kiely; L A Lipsitz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The journals of gerontology. Series A, Biological sciences and medical sciences     Volume:  53     ISSN:  1079-5006     ISO Abbreviation:  J. Gerontol. A Biol. Sci. Med. Sci.     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-06-08     Completed Date:  1998-06-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9502837     Medline TA:  J Gerontol A Biol Sci Med Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  M207-13     Citation Subset:  AIM; IM    
Affiliation:
Hebrew Rehabilitation Center for Aged Research and Training Institute, Department of Medicine of Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. susanm@magma.ca
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Analysis of Variance
Cohort Studies
Deglutition Disorders / mortality,  therapy*
Digestive System Diseases / mortality,  therapy*
Enteral Nutrition*
Female
Homes for the Aged
Humans
Intubation, Gastrointestinal
Male
Mastication*
Nursing Homes
Proportional Hazards Models
Survival Analysis
Time Factors
Washington
Grant Support
ID/Acronym/Agency:
AG-04390/AG/NIA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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