Objective:

To determine changes in the use of and outcomes from gastrostomy tube placement in a large cohort of patients across the North East of England and North Cumbria.

Approach:

• Study Design: Conducted six 3-month cross-sectional prospective audits covering all hospitals where gastrostomies are placed between 2004 and 2022.

Key Findings:

• 889 procedures were performed during the six audit periods.
• Mean age of patients decreased from 71 years in 2004 to 63 years in 2022.
• Estimated incidence of gastrostomy placement in 2022 was 19.2 per 100,000.
• The most common indication changed from stroke to dysphagia due to ear-nose-throat/upper gastrointestinal malignancy.
• The use of prophylactic antibiotics increased from 83% to 93% during the 18-year period.
• 7-day mortality reduced from 2% in 2004 to 1% in 2022.
• 30-day mortality rate reduced from 9% in 2004 to 2.5% in 2022.

Interpretation:

Changes in gastrostomy placement practice have occurred over time, including a shift in the most common indication and improved outcomes.

Limitations:

• The study reflects practices in a specific region and may not be generalizable to all areas.
• Data is based on audits which may have inherent biases.

Conclusion:

The study indicates a trend towards younger patients receiving gastrostomy tubes, increased use of prophylactic antibiotics, and reduced mortality rates.