The objective of this study was to examine survival with and without a percutaneous endoscopic gastrostomy (PEG) feeding tube using rigorous methods to account for selection bias. A second objective was to examine whether the timing of feeding tube insertion affected survival.
Prospective cohort study
All U.S. Nursing Homes
36,492 nursing home residents with advanced cognitive impairment from dementia and new problems eating studied between 1999–2007.
Survival following the development of the need for eating assistance and feeding tube insertion.
Of the 36,492 nursing home (NH) residents (88.4% white, mean age 84.9, 87.4% with one feeding tube risk factor), 1,957 (5.4%) had a feeding tube inserted within 1 year of developing eating problems. After multivariate analysis correcting for selection bias with propensity score weights, no difference was found in the survival of the 2 groups (AHR 1.03, 95% CI 0.94–1.13). Among residents who were tube-fed, the timing of PEG tube insertion relative to the onset of eating problems was not associated with improved survival post feeding tube insertion (AHR 1.01, 95% CI 0.86–1.20) comparing those persons with a PEG inserted within a month of developing an eating problem compared to later (4 months) insertion.
This national study confirms that neither insertion of PEG feeding tubes nor the timing of the insertion improve survival.
Keywords: Feeding tubes, timing of insertion, eating problems, dementia, survival