| Feeding tubes and the prevention or healing of pressure ulcers. | |
| | |
MedLine Citation:
|
PMID: 22782196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The evidence regarding the use of feeding tubes in persons with advanced dementia to prevent or heal pressure ulcers is conflicting. Using national data, we set out to determine whether percutaneous endoscopic gastrostomy (PEG) tubes prevent or help heal pressure ulcers in nursing home (NH) residents with advanced cognitive impairment (ACI). METHODS: A propensity-matched cohort study of NH residents with ACI and recent need for assistance in eating was conducted by matching each NH resident who had a feeding tube inserted during a hospitalization to 3 without a PEG tube inserted. Using the Minimum Data Set (MDS), we examined 2 outcomes: first, whether residents without a pressure ulcer developed a stage 2 or higher pressure ulcer (n = 1124 with PEG insertion); and second, whether NH residents with a pressure ulcer (n = 461) experienced improvement of the pressure ulcer by their first posthospitalization MDS assessment (mean [SD] time between evaluations, 24.6 [32.7] days). RESULTS: Matched residents with and without a PEG insertion showed comparable sociodemographic characteristic, rates of feeding tube risk factors, and mortality. Adjusted for risk factors, hospitalized NH residents receiving a PEG tube were 2.27 times more likely to develop a new pressure ulcer (95% CI, 1.95-2.65). Conversely, those with a pressure ulcer were less likely to have the ulcer heal when they had a PEG tube inserted (OR 0.70 [95% CI, 0.55-0.89]). CONCLUSIONS: Feeding tubes are not associated with prevention or improved healing of a pressure ulcer. Rather, our findings suggest that the use of PEG tube is associated with increased risk of pressure ulcers among NH residents with ACI. |
| | |
Authors:
|
Joan M Teno; Pedro Gozalo; Susan L Mitchell; Sylvia Kuo; Ana T Fulton; Vincent Mor |
Related Documents
:
|
10480026 - Vascular remodeling in hypertensive transgenic mice. 22789606 - How secure is the anastomosis between the proximal and distal body components of a fene... 19189836 - Hypertension and epidemiological factors among tribal labour population in gujarat. 23272446 - Efficacy of fix dose combination (atorvastatin and amlodipine) in treatment of uncontro... 18851926 - Sympathetic activation in congestive heart failure: reproducibility of neuroadrenergic ... 589876 - Effects of ultrafiltration on solute clearances in parallel plate dialyzers. |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: Archives of internal medicine Volume: 172 ISSN: 1538-3679 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2012 May |
Date Detail:
|
Created Date: 2012-07-11 Completed Date: 2012-09-21 Revised Date: 2013-05-14 |
Medline Journal Info:
|
Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
|
Languages: eng Pagination: 697-701 Citation Subset: AIM; IM |
Affiliation:
|
Center for Gerontology and Health Care Research, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Joan_Teno@brown.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Cognition Disorders / epidemiology*, physiopathology Cohort Studies Dementia / epidemiology*, physiopathology Enteral Nutrition / adverse effects* Female Humans Intubation, Gastrointestinal / instrumentation, methods Male Nursing Homes / statistics & numerical data Pressure Ulcer / epidemiology*, prevention & control, therapy Risk Factors Severity of Illness Index Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
|
1RC1AG036418-01/AG/NIA NIH HHS; K24 AG033640/AG/NIA NIH HHS; RC1 AG036418/AG/NIA NIH HHS |
| Comments/Corrections | |
Comment In:
|
Arch Intern Med. 2012 May 14;172(9):701-3
[PMID:
22782197
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Educating transurethral electroresection of the prostate is safe and efficient : Is training a risk ...
Next Document: Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninfe...