Gastrostomy placement and mortality among hospitalized Medicare beneficiaries.
BACKGROUND
Although the use of feeding tubes among older individuals stirs considerable controversy, population-based descriptive data regarding patient outcomes are scarce.


OBJECTIVE
To describe hospitalized Medicare beneficiaries having gastrostomies placed and their associated mortality rates.


METHODS
Retrospective cohort study.


METHODS
Hospitalized Medicare beneficiaries aged 65 years or older discharged in 1991 following gastrostomy placement (excluding individuals in health maintenance organizations).


METHODS
Mortality at 30 days, 1 year, and 3 years following gastrostomy and characteristics of individuals undergoing gastrostomy placement.


RESULTS
In 1991, claims reflecting gastrostomy insertion were submitted for 81105 older Medicare beneficiaries following hospital discharge. The in-hospital mortality rate was 15.3%. Cerebrovascular disease, neoplasms, fluid and electrolyte disorders, and aspiration pneumonia were the most common primary diagnoses. The overall mortality rate at 30 days was 23.9% (95% confidence interval [CI], 23.65%-24.2%), reaching 63.0% (95% CI, 62.7%-63.4%) at 1 year and 81.3% (95% CI, 81.0%-81.5%) by 3 years. One in 131 white and 1 in 58 black Medicare beneficiaries aged 85 years or older was discharged alive or deceased from a hospital in 1991 following gastrostomy placement.


CONCLUSIONS
Gastrostomies are frequently placed in older individuals and more often in blacks; mortality rates following placement are substantial.
Grant
M D
MD
West Suburban Hospital Family Practice Residency, Oak Park, IL, USA. markg@uic.edu
Rudberg
M A
MA
Brody
J A
JA
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005774:Gastrostomy / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D006278:Medicare; D009026:Mortality; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data