Morbidity and mortality after percutaneous endoscopic gastrostomy in children with neurological disability

Title

Morbidity and mortality after percutaneous endoscopic gastrostomy in children with neurological disability

Creator

Catto-Smith AG; Jimenez S

Publisher

Journal Of Gastroenterology And Hepatology

Date

2006

Subject

Child; Female; Humans; Male; Survival Rate; Adult; Treatment Outcome; Comorbidity; Survival Analysis; Risk Factors; Incidence; adolescent; Preschool; infant; Nutritional Failure; Australia/epidemiology; Endoscopy; Gastrointestinal/mortality; Gastrostomy/mortality; Malnutrition/mortality/prevention & control; Nervous System Diseases/mortality/surgery; Risk Assessment/methods

Description

BACKGROUND AND AIM: Gastrostomy placement has become an integral mechanism for delivering nutritional support to children with severe neurological disability. Its impact on gastroesophageal reflux and mortality remains contentious. We examined the morbidity and long-term mortality of a group of children with severe neurological disability after percutaneous endoscopic gastrostomy (PEG). METHODS: We retrospectively identified all children with severe neurological disability who had a PEG at the Royal Children's Hospital in Melbourne between 1990 and 1997. Data were obtained from medical records. RESULTS: Ninety-eight children with neurological disability (M:F 1.8:1.0; median age 3.5 years, interquartile range 1.1-8.7 years) had an initial PEG in this period and were able to be followed for 6-14 years. As a group, they were underweight for their age with a Z score at PEG of -3.52 (SD 3.33), but had increased weight-for-age Z scores by 1.05 after a mean period of 6.1 months. Fourteen subsequently required fundoplication for reflux. Mortality rates were 11% after 1 year, 21% after 2 years, 27% after 3 years and 39% after 13 years. Mortality was increased in those children who were older at the time of PEG (P = 0.06). Gastroesophageal reflux, underweight-for-age and gender were not significantly related to mortality. CONCLUSION: Children with severe neurological dysfunction who require gastrostomy feeding have a substantial long-term mortality, but this may be unrelated to PEG placement.
2006

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

734-738

Issue

4

Volume

21

Citation

Catto-Smith AG; Jimenez S, “Morbidity and mortality after percutaneous endoscopic gastrostomy in children with neurological disability,” Pediatric Palliative Care Library, accessed May 25, 2022, https://pedpalascnetlibrary.omeka.net/items/show/13463.

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