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Indications, Benefits, and Complications

Jerry O. Ciocon, MD; Felix A. Silverstone, MD; L. Michael Graver, MD; Cornelius J. Foley, MD

Arch Intern Med. 1988;148(2):429-433.

Abstract
• During an 11-month period, 70 tube-fed patients aged 65 to 95 years were studied prospectively to determine the indications, benefits, and complications of enteral alimentation. Indications for alimentation were refusal to swallow (35 patients [50%]), dysphagia without obstruction (33 [47%]), and esophageal obstruction (two [3%]). Nasogastric tubes (NGTs) were used initially in 69 patients; 15 of these subsequently required a gastrostomy tube (GT). One patient was treated initially with a gastrostomy. Indicators of nutritional status included weight, hemoglobin level, hematocrit, and serum albumin level. During the first two weeks the most common problems in the NGT group were agitation and self-extubation (36 patients [67%]) and aspiration pneumonia (23 [43%]). In GT patients the most common early problems were aspiration pneumonia (nine patients [56%]), tube dysfunction (eight [50%]), and agitation and extubation (seven [44%]). The common late problems were aspiration pneumonia (24 patients [44%] in the NGT group and nine [56%] in the GT group), and feeding tube dysfunction in six (38%) of the GT group. Self-extubation as a late problem was limited to the NGT group (21 patients [39%]). Twenty-eight (40%) of the 70 patients died during the study period.

(Arch Intern Med 1988;148:429-433)

Author Affiliations
From the Department of Geriatric Medicine, Jewish Institute for Geriatric Care (Drs Ciocon, Silverstone, and Foley), and the Department of Surgery, Long Island Jewish Medical Center (Dr Graver), New Hyde Park, NY.

Footnotes
Accepted for publication Sept 18, 1987.

Reprint requests to the Department of Geriatric Medicine, Jewish Institute for Geriatric Care, 271-11 76th Avenue, New Hyde Park, NY 11042 (Dr Ciocon).

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