title: A cross-sectional and longitudinal study of health-related quality of life after percutaneous gastrostomy.
abstract: OBJECTIVE
  Although gastrostomy feeding tends to have fewer interruptions than naso-gastric feeding and is cosmetically more acceptable; there is little information on health-related quality of life (HRQoL) in these patients. This study aimed to measure the health-related quality of life of patients after gastrostomy placement.
  
  
  METHODS
  Cross-sectional and prospective cohorts.
  
  
  METHODS
  Institutional and community-dwelling patients receiving nutritional support via a gastrostomy.
  
  
  METHODS
  For the cross-sectional cohort, all individuals who have received a percutaneous gastrostomy from our unit (January 1994-December 1996) were included; 55 of the 102 patients who were still living agreed to follow-up assessment. For the prospective cohort, all patients referred to our unit for percutaneous gastrostomy (March 1997-June 1998) were eligible to participate; 54 of 88 patients (62%) consented and were recruited.
  
  
  METHODS
  A cross-sectional assessment of patient outcome and health-related quality of life using SF-36, the Hospital Anxiety and Depression Scale and a disease-specific questionnaire (PEG-Qu) was carried out in patients in primary health care after receiving a gastrostomy. These assessments, plus the Modified Rankin Scale, were performed on patients studied at the time of gastrostomy placement, and after 1, 6 and 12 months of follow-up.
  
  
  RESULTS
  HRQoL questionnaires could be answered in less than half the patients. An overall rating of the effect of the gastrostomy on the patients' and carers' HRQoL showed a positive effect in 55% and 80%, respectively. A positive impression of the gastrostomy by the patient did not necessarily reflect an improvement in their nutritional status. Assessment of HRQoL in a cohort of gastrostomy patients showed deficiencies in the physical domain but not mental function (anxiety or depression), energy or health perception. Neither physical function nor level of cognition at time of gastrostomy placement appear to be able to predict patient survival. Nutritional outcome was not related to HRQoL outcome.
  
  
  CONCLUSIONS
  The majority of patients and carers rate gastrostomy positively. Patients who were 75 years or older had a poorer survival compared to younger patients, but gender, physical or cognitive function had no predictive value on survival.
authors.affiliation: Department of Medical Sciences, The University of Edinbrugh, UK.
authors.forename: E
authors.initials: E
authors.lastname: Bannerman
authors.forename: J
authors.initials: J
authors.lastname: Pendlebury
authors.forename: F
authors.initials: F
authors.lastname: Phillips
authors.forename: S
authors.initials: S
authors.lastname: Ghosh
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016019:Survival Analysis