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Survival analysis in percutaneous endoscopic gastrostomy feeding: a worse outcome in patients with dementia
Sanders DS, Carter MJ, D'Silva J, James G, Bolton RP, Bardhan KD.. The American journal of gastroenterology, 2000-06-01
Topic: Risk, prevention and care in population studies
Objective Percutaneous endoscopic gastrostomy (PEG) feeding has been validated in specific clinical situations such as acute stroke with dysphagia and oropharyngeal malignancy. The perception that gastrostomy insertion is safe and technically simple has led to an increase in the demands for PEG insertion, encompassing clinical applications such as in patients with dementia, in whom its role has not been justified. The purpose of this study was to compare the mortality of patients with dementia who were fed by PEG to that of other subgroups of patients requiring gastrostomy feeding. Methods The study focused on a cohort of 361 consecutive patients requiring PEG feeding between August 1992 and July 1997 from two District General Hospitals (Rotherham District General Hospital and Doncaster Royal Infirmary) in South Yorkshire. A retrospective cohort survival analysis was performed using the Kaplan-Meier survival method and Cox proportional hazards analysis. Results In all patients requiring gastrostomy feeding there is a high initial mortality of 28% at 30 days. However, patients with dementia have a worse prognosis compared to other subgroups, with 54% having died at 1 month and 90% at 1 yr (log rank test p < 0.0001). This difference remained significant (log rank p < 0.0001) after adjusting for age at the time of PEG insertion. Conclusions This is the first demonstration in the United Kingdom that the mortality of patients with dementia who are fed by gastrostomy is considerable. Consequently, we may wish to advise against gastrostomy feeding in selected patients within this clinical setting.
Key findings
- Results In all patients requiring gastrostomy feeding there is a high initial mortality of 28% at 30 days.
- However, patients with dementia have a worse prognosis compared to other subgroups, with 54% having died at 1 month and 90% at 1 yr (log rank test p < 0.0001).
- This difference remained significant (log rank p < 0.0001) after adjusting for age at the time of PEG insertion.
Study details
- Study designretrospective cohort
- Evidence strengthModerate
How this study scored 52/100
Published in a peer-reviewed journal, and it is a retrospective cohort study, reconstructed from past records. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 30 of the 58 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of gastroenterology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A retrospective cohort study, reconstructed from past records |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2000 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10894581) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 30 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 30 of the 58 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Sanders, D. S., Carter, M. J., D'Silva, J., James, G., Bolton, R. P., & Bardhan, K. D. (2000). Survival analysis in percutaneous endoscopic gastrostomy feeding: a worse outcome in patients with dementia. The American journal of gastroenterology. https://doi.org/10.1111/j.1572-0241.2000.02079.x
Vancouver
Sanders DS, Carter MJ, D'Silva J, James G, Bolton RP, Bardhan KD. Survival analysis in percutaneous endoscopic gastrostomy feeding: a worse outcome in patients with dementia. The American journal of gastroenterology. 2000. doi:10.1111/j.1572-0241.2000.02079.x. PMID: 10894581.
BibTeX
@article{sanders2000-10894581,
author = {Sanders, D. S. and Carter, M. J. and D'Silva, J. and James, G. and Bolton, R. P. and Bardhan, K. D.},
title = {{Survival analysis in percutaneous endoscopic gastrostomy feeding: a worse outcome in patients with dementia}},
journal = {The American journal of gastroenterology},
year = {2000},
doi = {10.1111/j.1572-0241.2000.02079.x},
pmid = {10894581},
url = {https://doi.org/10.1111/j.1572-0241.2000.02079.x}
}
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