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Association between delivery methods for enteral nutrition and physical status among older adults
BMC Nutrition Pub Date : 2020-01-14 , DOI: 10.1186/s40795-019-0318-3
Tetsuro Hayashi 1, 2 , Masato Matsushima 2 , Hidetaka Wakabayashi 3 , Seiji Bito 1
Affiliation  

The physical status of patients who received enteral nutrition is still unclear. We aimed to compare the physical functional status among older adult patients who underwent percutaneous endoscopic gastrostomy (PEG) and those with nasogastric feeding. We conducted a retrospective cohort study in an acute care hospital from August 1, 2009 to March 31, 2015. We included older adult patients (age ≥ 65 years) who were administered PEG or nasogastric feeding during hospitalization and received enteral nutrition for ≥14 days. We excluded patients who were completely bedridden at the administration of enteral nutrition. The primary outcome was death or becoming bedridden at discharge. The incidence of being bedridden among the patients who survived and received enteral nutrition at discharge was also compared according to the enteral nutrition method used. Among the 181 patients who were administered enteral nutrition during hospitalization, 40 patients (22%) died and 66 patients (36%) were bedridden at discharge. The proportions of patients who fully resumed oral intake were 30% in the nasogastric group and 2.3% in the PEG group. The adjusted odds ratios comparing PEG feeding to nasogastric feeding were 0.38 (95% CI, 0.16–0.93) for death or being bedridden and 0.09 (95% CI, 0.02–0.40) for being bedridden among the patients who were receiving enteral nutrition at discharge. Among older adult patients who were administered enteral nutrition, more than half of these patients died or became bedridden. PEG feeding could be associated with a lower risk of becoming bedridden or death in comparison with nasogastric feeding, although PEG feeding may be offered to the most mobile/ambulatory patients within clinical decision-making. Clinicians should carefully consider the administration and choice of enteral nutrition methods, when considering the prognosis of the patients.

中文翻译:

老年人肠内营养给药方式与身体状况的关系

接受肠内营养的患者身体状况尚不清楚。我们旨在比较接受经皮内镜下胃造口术 (PEG) 和鼻胃喂养的老年患者的身体功能状态。我们于 2009 年 8 月 1 日至 2015 年 3 月 31 日在一家急症护理医院进行了一项回顾性队列研究。我们纳入了住院期间接受 PEG 或鼻饲并接受肠内营养≥14 天的老年患者(年龄 ≥ 65 岁) . 我们排除了接受肠内营养时完全卧床不起的患者。主要结局是出院时死亡或卧床不起。还根据所使用的肠内营养方法比较了存活并在出院时接受肠内营养的患者卧床不起的发生率。住院期间给予肠内营养的181例患者中,40例(22%)死亡,66例(36%)出院时卧床不起。完全恢复经口摄入的患者比例在鼻胃组为 30%,在 PEG 组为 2.3%。在出院时接受肠内营养的患者中,比较 PEG 喂养与鼻胃喂养的调整优势比为 0.38(95% CI,0.16-0.93)死亡或卧床不起和卧床不起的 0.09(95% CI,0.02-0.40) . 在接受肠内营养的老年患者中,超过一半的患者死亡或卧床不起。与鼻饲相比,PEG 喂养可能与卧床不起或死亡的风险较低有关,尽管 PEG 喂养可能会提供给临床决策中最移动/不卧床的患者。在考虑患者的预后时,临床医生应仔细考虑肠内营养方法的给药和选择。
更新日期:2020-04-22
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