title: A descriptive study of nasogastric tube feeding among geriatric inpatients in Malaysia: utilization, complications, and caregiver opinions.
abstract: The strong emphasis on feeding in Asian cultures may influence decisions for nasogastric (NG) tube feeding in geriatric inpatients. We evaluated the utility, complications, and opinions of caregivers toward NG tube feeding in an acute geriatric ward in a teaching hospital in Kuala Lumpur. Consecutive patients aged 65 years and older receiving NG tube feeding were included. Sociodemographic, clinical, and laboratory indices were recorded. Opinion on NG tube feeding were evaluated through face-to-face interviews with caregivers, recruited through convenience sampling. Of 432 patients admitted, 96 (22%), age ± standard deviation = 80.8 ± 7.4 years, received NG tube feeding. The complication and mortality rates were 69% and 38%, respectively. Diabetes (odds ratio [95% confidence interval] = 3.34 [1.07, 10.44], aspiration pneumonia (8.15 [2.43, 27.24]), impaired consciousness (3.13 [1.05, 9.36]), and albumin ≤26 g/dl (4.43 [1.46, 13.44]) were independent predictors of mortality. Other relatives were more likely than spouses (23.5 [3.59, 154.2]) and caregivers with tertiary education more likely than those with no formal education ( 18 [1.23, 262.7]) to agree to NG feeding. Sixty-four percent of caregivers felt NG tube feeding was appropriate at the end of life, mostly due to the fear of starvation. NG tube feeding is widely used in our setting, despite high complication and mortality rates, with likely influences from cultural emphasis on feeding.
authors: a Division of Geriatric Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia.
authors: Nordiana
authors: N
authors: Nordin
authors: Shahrul Bahyah
authors: SB
authors: Kamaruzzaman
authors: Ai-Vyrn
authors: AV
authors: Chin
authors: Philip J H
authors: PJ
authors: Poi
authors: Maw Pin
authors: MP
authors: Tan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health / Q000208:ethnology; D017028:Caregivers; D058620:Elder Nutritional Physiological Phenomena; D004750:Enteral Nutrition / Q000009:adverse effects*; D005190:Family / Q000208:ethnology; D005260:Female; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008296:Malaysia; D008297:Male; D010818:Practice Patterns, Physicians'; D016312:Treatment Refusal / Q000208:ethnology
keywords: artificial nutrition; eating perceptions; end of life care; family caregivers; geriatrics; nasogastric tube feeding