This Article Full Text Full Text (PDF) All Versions of this Article: 0148607108321709v1 33/1/62    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Gaines, D. I. Articles by DeLegge, M. H. Search for Related Content PubMed PubMed Citation Articles by Gaines, D. I. Articles by DeLegge, M. H. Social Bookmarking                         What's this?

Dementia and Cognitive Impairment Are Not Associated With Earlier Mortality After Percutaneous Endoscopic Gastrostomy

From the Division of Gastroenterology/Hepatology, Medial University of South Carolina, Charleston, South Carolina.

Address correspondence to: Mark H. DeLegge, MD, Digestive Disease Center, Ashley River Tower, 7th Floor, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC 29425; e-mail: deleggem{at}musc.edu.

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.

Key Words: dementia • cognitive impairment • percutaneous endoscopic gastrostomy • mortality

This version was published on January 1, 2009

Journal of Parenteral and Enteral Nutrition, Vol. 33, No. 1, 62-66 (2009)
DOI: 10.1177/0148607108321709


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. H. DeLegge Tube Feeding in Patients With Dementia: Where Are We? Nutr Clin Pract, April 1, 2009; 24(2): 214 - 216. [Abstract] [Full Text] [PDF]