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Dementia and Cognitive Impairment Are Not Associated With Earlier Mortality After Percutaneous Endoscopic Gastrostomy
Ist Teil von
JPEN. Journal of parenteral and enteral nutrition, 2009-01, Vol.33 (1), p.62-66
Ort / Verlag
Thousand Oaks, CA: SAGE Publications
Erscheinungsjahr
2009
Quelle
Wiley-Blackwell Journals
Beschreibungen/Notizen
Background: Studies have shown varying results with regard to risk
factors for mortality after percutaneous endoscopic gastrostomy (PEG).
Objectives: To examine the time to death in patients with dementia or
significant cognitive impairment (SCI) due to neurologic injury who had
undergone PEG compared with patients without either of these diagnoses, and to
examine risk factors for 30-day mortality after PEG. Methods:
Patients who had undergone PEG over a 2-year period were identified. Local
medical records and the Social Security Death Index were reviewed to ascertain
the patients' age, gender, serum albumin, diagnoses, presence or absence of
dementia or SCI, presence or absence of complications related to PEG, and
length of survival after PEG. The Charlson Comorbidity Index (CCI) was
calculated based on the medical diagnoses at the time of PEG.
Results: One hundred ninety patients were identified. Forty-five
carried a diagnosis of dementia and/or SCI compared with 145 who did not.
Median survival of patients with dementia or SCI was 53 days compared with 78
days in patients without these diagnoses (P = .85). Age (odds ratio
[OR] 1.1, 95% confidence interval [CI] 1.04-1.12) and albumin (OR 0.43, 95% CI
0.22-0.84) were associated with 30-day mortality, whereas gender (OR 1.2, 95%
CI 0.47-2.90), CCI (OR 1.1, 95% CI 0.86-1.32), and presence of PEG-related
complications (OR 1.6, 95% CI 0.36-6.76) were not. Conclusions: Age
and serum albumin are risk factors for 30-day mortality after PEG. Patients
with dementia or SCI do not have a significantly shorter survival after PEG
than patients with intact cognitive function.