Trends in Indications and Outcomes of Gastrostomy Tube Insertion

Overview

This study reports on the trends in gastrostomy tube insertion practices and outcomes over an 18-year period in Northern England. Key findings include a shift in primary indications from stroke to dysphagia due to malignancies, a decrease in mortality rates, and increased use of prophylactic antibiotics.

Background

Gastrostomy tube insertion is a critical procedure for patients requiring long-term enteral feeding due to inadequate oral intake. This study addresses the lack of large-scale audit data on gastrostomy practices in the UK.

Data Highlights

Key Findings

• The mean age of patients undergoing gastrostomy decreased from 71 years in 2004 to 63 years in 2022.
• The estimated incidence of gastrostomy placement in 2022 was 19.2 per 100,000 population.
• The most common indication for gastrostomy shifted from stroke to dysphagia due to ear-nose-throat/upper gastrointestinal malignancies.
• The use of prophylactic antibiotics increased from 83% to 93% over the study period.
• 7-day mortality decreased from 2% in 2004 to 1% in 2022.
• 30-day mortality reduced from 9% in 2004 to 2.5% in 2022.

Clinical Implications

The findings indicate a need for ongoing assessment of gastrostomy practices to ensure they align with current clinical guidelines and patient needs. The reduction in mortality rates suggests improvements in procedural safety and patient selection.

Conclusion

This study reports significant changes in gastrostomy tube insertion practices and outcomes over time.

Related Resources & Content

1. Endoscopic duodenal stenting demonstrates effectiveness but has a higher reoperation rate compared to gastrojejunostomy in palliative care for gastric outlet obstruction.
2. Impact of Gastrostomy Insertion on Gastric Functionality in Pediatric Patients: A Prospective Cohort Analysis.
3. Comparing Linear and Circular Techniques: An Overview of Anastomotic Ulcers Following Gastric Bypass Surgery.
4. Risks and Benefits Associated With Gastrostomy Tubes for Patients With Cancer.
5. American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: summary and recommendations.
6. A systematic review comparing the outcomes of patients undergoing endoscopic versus interventional radiologic gastrostomy: a meta-analysis of the randomised control trials.
7. Endoscopic management of enteral tubes in adult patients – Part 2: Peri- and post-procedural management.
8. American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: summary and recommendations
9. TTP4.10 A systematic review comparing the outcomes of patients undergoing endoscopic versus interventional radiologic gastrostomy: a meta-analysis of the randomised control trials | BJS | Oxford Academic
10. Endoscopic management of enteral tubes in adult patients – Part 2: Peri- and post-procedural management | ESGE