Factors Impacting Long-Term Gastrostomy Tube Dependence in Infants with Congenital Heart Disease
•Overall, 84% of infants with congenital heart disease continued to use a gastrostomy tube for enteral nutrition at one-year.•Infants tolerating minimal oral nutrition before gastrostomy placement, those with prolonged hospitalization after placement, and those demonstrating difficulty with oral fee...
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| Veröffentlicht in: | The Journal of surgical research 2022-02, Vol.270, p.455-462 |
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| container_title | The Journal of surgical research |
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| creator | Mahdi, Elaa M. Tran, Nhu N. Ourshalimian, Shadassa Sanborn, Stephanie Alquiros, Maria Theresa Squillaro, Anthony Lascano, Danny Herrington, Cynthia Kelley-Quon, Lorraine I. |
| description | •Overall, 84% of infants with congenital heart disease continued to use a gastrostomy tube for enteral nutrition at one-year.•Infants tolerating minimal oral nutrition before gastrostomy placement, those with prolonged hospitalization after placement, and those demonstrating difficulty with oral feeds at discharge were more likely to use their gastrostomy tube at one-year.•The majority of infants experienced clinic or emergency room visits for gastrostomy tube complications, regardless of use at one-year
Infants with congenital heart disease (CHD) often experience oral feeding intolerance requiring gastrostomy (GT). Complications related to GT use are common. The study aim was to identify factors associated with continued GT use at one-year.
A retrospective cohort study was performed at a tertiary children's hospital using the Society of Thoracic Surgeons database and patients’ electronic medical record. Infants |
| doi_str_mv | 10.1016/j.jss.2021.09.023 |
| format | Article |
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Infants with congenital heart disease (CHD) often experience oral feeding intolerance requiring gastrostomy (GT). Complications related to GT use are common. The study aim was to identify factors associated with continued GT use at one-year.
A retrospective cohort study was performed at a tertiary children's hospital using the Society of Thoracic Surgeons database and patients’ electronic medical record. Infants <1-year with CHD who underwent cardiac and GT surgery between January 2014-October 2019 were identified. Patient demographics, preoperative feeding, clinical variables, and GT use at one-year was evaluated. A separate cohort discharged with a nasogastric tube (NGT) was identified for longitudinal comparisons.
Of 137 infants who received a GT, 115 (84%) continued using their GT at one-year. Factors associated with continued GT use included lower median percent of goal oral feeding before GT placement (0% IQR 0-6.5 versus 3.7% IQR 0-31), prolonged hospitalization after GT placement (36% versus 14%, P-value = 0.048), and failure to take oral feeds at discharge (69% versus 27%, P-value <0.001). There was no difference in demographics or clinical comorbidities between groups. Clinic/emergency room visits for GT complications were common (72%). Eight infants discharged with a NGT did not require GT placement.
Patients with CHD tolerating minimal oral nutrition before GT placement, prolonged hospitalization after GT, and difficulty with oral feeds at discharge were more likely to use their GT at 1-year. Outpatient NGT feeding is feasible for select infants with CHD. Efforts to optimize care for this complex, device-dependent population are warranted to minimize risks and facilitate family engagement for long-term care.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2021.09.023</identifier><identifier>PMID: 34800791</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Congenital heart disease ; Feeding ; Gastrostomy tube</subject><ispartof>The Journal of surgical research, 2022-02, Vol.270, p.455-462</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-b3f7312b1f244383e4d48cdfde78699f21a65f478f0a59ee8cf6e0fef61290443</citedby><cites>FETCH-LOGICAL-c353t-b3f7312b1f244383e4d48cdfde78699f21a65f478f0a59ee8cf6e0fef61290443</cites><orcidid>0000-0002-5380-6142 ; 0000-0002-2227-0365 ; 0000-0002-6750-5471 ; 0000-0003-2091-665X ; 0000-0002-1735-0897 ; 0000-0002-3429-6415</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2021.09.023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34800791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahdi, Elaa M.</creatorcontrib><creatorcontrib>Tran, Nhu N.</creatorcontrib><creatorcontrib>Ourshalimian, Shadassa</creatorcontrib><creatorcontrib>Sanborn, Stephanie</creatorcontrib><creatorcontrib>Alquiros, Maria Theresa</creatorcontrib><creatorcontrib>Squillaro, Anthony</creatorcontrib><creatorcontrib>Lascano, Danny</creatorcontrib><creatorcontrib>Herrington, Cynthia</creatorcontrib><creatorcontrib>Kelley-Quon, Lorraine I.</creatorcontrib><title>Factors Impacting Long-Term Gastrostomy Tube Dependence in Infants with Congenital Heart Disease</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>•Overall, 84% of infants with congenital heart disease continued to use a gastrostomy tube for enteral nutrition at one-year.•Infants tolerating minimal oral nutrition before gastrostomy placement, those with prolonged hospitalization after placement, and those demonstrating difficulty with oral feeds at discharge were more likely to use their gastrostomy tube at one-year.•The majority of infants experienced clinic or emergency room visits for gastrostomy tube complications, regardless of use at one-year
Infants with congenital heart disease (CHD) often experience oral feeding intolerance requiring gastrostomy (GT). Complications related to GT use are common. The study aim was to identify factors associated with continued GT use at one-year.
A retrospective cohort study was performed at a tertiary children's hospital using the Society of Thoracic Surgeons database and patients’ electronic medical record. Infants <1-year with CHD who underwent cardiac and GT surgery between January 2014-October 2019 were identified. Patient demographics, preoperative feeding, clinical variables, and GT use at one-year was evaluated. A separate cohort discharged with a nasogastric tube (NGT) was identified for longitudinal comparisons.
Of 137 infants who received a GT, 115 (84%) continued using their GT at one-year. Factors associated with continued GT use included lower median percent of goal oral feeding before GT placement (0% IQR 0-6.5 versus 3.7% IQR 0-31), prolonged hospitalization after GT placement (36% versus 14%, P-value = 0.048), and failure to take oral feeds at discharge (69% versus 27%, P-value <0.001). There was no difference in demographics or clinical comorbidities between groups. Clinic/emergency room visits for GT complications were common (72%). Eight infants discharged with a NGT did not require GT placement.
Patients with CHD tolerating minimal oral nutrition before GT placement, prolonged hospitalization after GT, and difficulty with oral feeds at discharge were more likely to use their GT at 1-year. Outpatient NGT feeding is feasible for select infants with CHD. Efforts to optimize care for this complex, device-dependent population are warranted to minimize risks and facilitate family engagement for long-term care.</description><subject>Congenital heart disease</subject><subject>Feeding</subject><subject>Gastrostomy tube</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kEtPAjEUhRujEUR_gBvTpZsZ-xhmpnFlQJCExA2ua-ncYgnTwbZo-PeWgC5d3UfOOcn5ELqlJKeElg_rfB1CzgijORE5YfwM9SkRw6wuK36O-oQwlhU1KXroKoQ1Sbeo-CXq8fQklaB99D5ROnY-4Fm7TZt1Kzzv3CpbgG_xVIXouxC7do8XuyXgMWzBNeA0YOvwzBnlYsDfNn7gUXKBs1Ft8AsoH_HYBlABrtGFUZsAN6c5QG-T58XoJZu_Tmejp3mm-ZDHbMlNxSlbUsOKgtcciqaodWMaqOpSCMOoKoemqGpD1FAA1NqUQAyYkjJBkmWA7o-5W9997iBE2dqgYbNRDrpdkKxM7euClzxJ6VGqU7ngwcitt63ye0mJPICVa5nAygNYSYRMYJPn7hS_W7bQ_Dl-SSbB41EAqeSXBS-DtgdSjfWgo2w6-0_8DxQ2iSY</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Mahdi, Elaa M.</creator><creator>Tran, Nhu N.</creator><creator>Ourshalimian, Shadassa</creator><creator>Sanborn, Stephanie</creator><creator>Alquiros, Maria Theresa</creator><creator>Squillaro, Anthony</creator><creator>Lascano, Danny</creator><creator>Herrington, Cynthia</creator><creator>Kelley-Quon, Lorraine I.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5380-6142</orcidid><orcidid>https://orcid.org/0000-0002-2227-0365</orcidid><orcidid>https://orcid.org/0000-0002-6750-5471</orcidid><orcidid>https://orcid.org/0000-0003-2091-665X</orcidid><orcidid>https://orcid.org/0000-0002-1735-0897</orcidid><orcidid>https://orcid.org/0000-0002-3429-6415</orcidid></search><sort><creationdate>202202</creationdate><title>Factors Impacting Long-Term Gastrostomy Tube Dependence in Infants with Congenital Heart Disease</title><author>Mahdi, Elaa M. ; Tran, Nhu N. ; Ourshalimian, Shadassa ; Sanborn, Stephanie ; Alquiros, Maria Theresa ; Squillaro, Anthony ; Lascano, Danny ; Herrington, Cynthia ; Kelley-Quon, Lorraine I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-b3f7312b1f244383e4d48cdfde78699f21a65f478f0a59ee8cf6e0fef61290443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Congenital heart disease</topic><topic>Feeding</topic><topic>Gastrostomy tube</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahdi, Elaa M.</creatorcontrib><creatorcontrib>Tran, Nhu N.</creatorcontrib><creatorcontrib>Ourshalimian, Shadassa</creatorcontrib><creatorcontrib>Sanborn, Stephanie</creatorcontrib><creatorcontrib>Alquiros, Maria Theresa</creatorcontrib><creatorcontrib>Squillaro, Anthony</creatorcontrib><creatorcontrib>Lascano, Danny</creatorcontrib><creatorcontrib>Herrington, Cynthia</creatorcontrib><creatorcontrib>Kelley-Quon, Lorraine I.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahdi, Elaa M.</au><au>Tran, Nhu N.</au><au>Ourshalimian, Shadassa</au><au>Sanborn, Stephanie</au><au>Alquiros, Maria Theresa</au><au>Squillaro, Anthony</au><au>Lascano, Danny</au><au>Herrington, Cynthia</au><au>Kelley-Quon, Lorraine I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Impacting Long-Term Gastrostomy Tube Dependence in Infants with Congenital Heart Disease</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2022-02</date><risdate>2022</risdate><volume>270</volume><spage>455</spage><epage>462</epage><pages>455-462</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>•Overall, 84% of infants with congenital heart disease continued to use a gastrostomy tube for enteral nutrition at one-year.•Infants tolerating minimal oral nutrition before gastrostomy placement, those with prolonged hospitalization after placement, and those demonstrating difficulty with oral feeds at discharge were more likely to use their gastrostomy tube at one-year.•The majority of infants experienced clinic or emergency room visits for gastrostomy tube complications, regardless of use at one-year
Infants with congenital heart disease (CHD) often experience oral feeding intolerance requiring gastrostomy (GT). Complications related to GT use are common. The study aim was to identify factors associated with continued GT use at one-year.
A retrospective cohort study was performed at a tertiary children's hospital using the Society of Thoracic Surgeons database and patients’ electronic medical record. Infants <1-year with CHD who underwent cardiac and GT surgery between January 2014-October 2019 were identified. Patient demographics, preoperative feeding, clinical variables, and GT use at one-year was evaluated. A separate cohort discharged with a nasogastric tube (NGT) was identified for longitudinal comparisons.
Of 137 infants who received a GT, 115 (84%) continued using their GT at one-year. Factors associated with continued GT use included lower median percent of goal oral feeding before GT placement (0% IQR 0-6.5 versus 3.7% IQR 0-31), prolonged hospitalization after GT placement (36% versus 14%, P-value = 0.048), and failure to take oral feeds at discharge (69% versus 27%, P-value <0.001). There was no difference in demographics or clinical comorbidities between groups. Clinic/emergency room visits for GT complications were common (72%). Eight infants discharged with a NGT did not require GT placement.
Patients with CHD tolerating minimal oral nutrition before GT placement, prolonged hospitalization after GT, and difficulty with oral feeds at discharge were more likely to use their GT at 1-year. Outpatient NGT feeding is feasible for select infants with CHD. Efforts to optimize care for this complex, device-dependent population are warranted to minimize risks and facilitate family engagement for long-term care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34800791</pmid><doi>10.1016/j.jss.2021.09.023</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5380-6142</orcidid><orcidid>https://orcid.org/0000-0002-2227-0365</orcidid><orcidid>https://orcid.org/0000-0002-6750-5471</orcidid><orcidid>https://orcid.org/0000-0003-2091-665X</orcidid><orcidid>https://orcid.org/0000-0002-1735-0897</orcidid><orcidid>https://orcid.org/0000-0002-3429-6415</orcidid></addata></record> |
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| subjects | Congenital heart disease Feeding Gastrostomy tube |
| title | Factors Impacting Long-Term Gastrostomy Tube Dependence in Infants with Congenital Heart Disease |
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