title: Tube feeding and quality of life in children with severe neurological impairment.
abstract: OBJECTIVE
  To assess the quality of life (QOL) of neurologically impaired children before and after gastrostomy (G) and gastrojejunostomy (GJ) tube insertion.
  
  
  METHODS
  This was a prospective longitudinal study of children with severe neurological impairment who underwent G or GJ tube insertion. At baseline, and at 6 and 12 months after tube insertion, parents rated (1) global QOL and health-related quality of life (HRQOL) using 10 cm visual analogue scales, with 10 representing maximal QOL and (2) HR-QOL using a questionnaire-based measure.
  
  
  RESULTS
  Fifty patients, 45 and five of whom underwent G and GJ tube insertion, respectively, were enrolled with a median age of 591 days. Forty-two had a static neurological disorder, and eight had a progressive neurological disorder. The mean weight for age z score increased significantly over time: -2.8 at baseline and -1.8 at 12 months. The mean QOL and HR-QOL scores at baseline were 5.5 and 5.6 out of 10, respectively. There was no significant change in these scores at 6 and 12 months post-tube insertion. Children with a progressive versus a static neurological disorder had a significantly lower QOL over time. Ease of medication administration as well as feeding showed a significant improvement in scores from baseline to 12 months. Parents felt that the G and GJ tube had a positive impact on their child's health at 6 months (86%) and 12 months (84%).
  
  
  CONCLUSIONS
  QOL as rated by parents did not increase following insertion of a G or GJ tube in neurologically impaired children. However, parents felt that the tube had a positive impact on their child's health, particularly with regards to feeding and administration of medications.
authors.affiliation: Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Canada. sanjay.mahant@sickkids.ca
authors.forename: S
authors.initials: S
authors.lastname: Mahant
authors.forename: J N
authors.initials: JN
authors.lastname: Friedman
authors.forename: B
authors.initials: B
authors.lastname: Connolly
authors.forename: C
authors.initials: C
authors.lastname: Goia
authors.forename: C
authors.initials: C
authors.lastname: Macarthur
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000178:diet therapy* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019636:Neurodegenerative Diseases / Q000178:diet therapy* / Q000523:psychology; D009752:Nutritional Status; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D015430:Weight Gain