Tube feedings in elderly patients. Indications, benefits, and complications.
During an 11-month period, 70 tube-fed patients aged 65 to 95 years were studied prospectively to determine the indications, benefits, and complications of enteral alimentation. Indications for alimentation were refusal to swallow (35 patients [50%], dysphagia without obstruction (33 [47%]), and esophageal obstruction (two [3%]). Nasogastric tubes (NGTs) were used initially in 69 patients; 15 of these subsequently required a gastrostomy tube (GT). One patient was treated initially with a gastrostomy. Indicators of nutritional status included weight, hemoglobin level, hematocrit, and serum albumin level. During the first two weeks the most common problems in the NGT group were agitation and self-extubation (36 patients [67%]) and aspiration pneumonia (23 [43%]). In GT patients the most common early problems were aspiration pneumonia (nine patients [56%]), tube dysfunction (eight [50%]), and agitation and extubation (seven [44%]). The common late problems were aspiration pneumonia (24 patients [44%] in the NGT group and nine [56%] in the GT group), and feeding tube dysfunction in six (38%) of the GT group. Self-extubation as a late problem was limited to the NGT group (21 patients [39%]). Twenty-eight (40%) of the 70 patients died during the study period.
D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D003680:Deglutition Disorders / Q000628:therapy; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D004935:Esophageal Diseases / Q000628:therapy; D005069:Evaluation Studies as Topic; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007326:Institutionalization; D008297:Male; D009752:Nutritional Status; D011015:Pneumonia, Aspiration / Q000209:etiology; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000209:etiology