A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people

T. Dwolatzky, S. Berezovski, R. Friedmann, J. Paz, A. M. Clarfield, J. Stessman, R. Hamburger, E. Jaul, Y. Friedlander, A. Rosin, M. Sonnenblick

Research output: Contribution to journalArticlepeer-review

98 Scopus citations

Abstract

Objective: To compare the indications for and the outcome of long-term enteral feeding by nasogastric tube (NGT) with that of percutaneous endoscopic gastrostomy (PEG) tube. Design: A prospective, multicenter cohort study. Setting: Acute geriatric units and long-term care (LTC) hospitals in Jerusalem, Israel. Participants: 122 chronic patients aged 65 years and older for whom long-term enteral feeding was indicated as determined by the treating physician. Patients with acute medical conditions at the time of tube placement were excluded. Measurements: We examined the indications for enteral feeding, nutritional status, outcome and complications in all subjects. Subjects were followed for a minimum period of six months. Results: Although the PEG patients were older and had a higher incidence of dementia, there was an improved survival in those patients with PEG as compared to NGT (hazard ratio (HR) = 0.41; 95% confidence interval (Cl) 0.22-0.76; P = 0.01). Also, the patients with PEG had a lower rate of aspiration (HR = 0.48; 95% CI 0.26-0.89) and self-extubation (HR = 0.17; 95% CI 0.05-0.58) than those with NGT. Apart from a significant improvement in the serum albumin level at the 4-week follow-up assessment in the patients with PEG compared to those with NGT (adjusted mean 3.35 compared to 3.08; F = 4.982), nutritional status was otherwise similar in both groups. Conclusion: In long-term enteral feeding, in a selected group of non-acute patients, the use of PEG was associated with improved survival, was better tolerated by the patient and was associated with a lower incidence of aspiration. A randomized controlled study is needed to determine whether PEG is truly superior to NGT.

Original languageEnglish
Pages (from-to)535-540
Number of pages6
JournalClinical Nutrition
Volume20
Issue number6
DOIs
StatePublished - 1 Jan 2001
Externally publishedYes

Keywords

  • Elderly
  • Enteral feeding
  • Nasogastric tube
  • Percutaneous endoscopic gastrostomy

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine

Fingerprint

Dive into the research topics of 'A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people'. Together they form a unique fingerprint.

Cite this