Are we using percutaneous endoscopic gastrostomy appropriately in the elderly?
Many percutaneous endoscopic gastrostomy patients are very elderly and frail. Outcomes after percutaneous endoscopic gastrostomy have been disappointing in some instances: about a fifth of patients are dead within 30 days of the procedure and those that survive often have a severely impaired functional status. Many healthy elderly persons would not wish for tube feeding especially in the context of advanced dementia. Despite this the number of patients receiving percutaneous endoscopic gastrostomy continues to increase. The case mix, outcomes and ethical issues of percutaneous endoscopic gastrostomy feeding are reviewed. Guidance on selection of appropriate patients is given.
Skelly
Robert H
RH
Derbyshire Royal Infirmary, London Road, Derby DE1 2QY, UK. rob@skelly.com
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000628:therapy*; D004992:Ethics, Medical; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications; D011788:Quality of Life; D012720:Severity of Illness Index; D013727:Terminal Care; D016896:Treatment Outcome