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Gastric feeding tubes may raise pressure ulcer risk
Date:5/14/2012

PROVIDENCE, R.I. [Brown University] A new study led by Brown University researchers reports that percutaneous endoscopic gastric (PEG) feeding tubes, long assumed to help bedridden dementia patients stave off or overcome pressure ulcers, may instead make the horrible sores more likely to develop or not improve.

The analysis of thousands of nursing home patients with advanced dementia appears in the May 14 edition of the Archives of Internal Medicine.

"This study provides new information about the risks of feeding tube insertion in people with advanced cognitive impairment," said lead author Dr. Joan Teno, a gerontologist and professor of health services, policy, and practice in the Public Health Program at Brown. "We see a substantial risk of people developing a stage II and higher pressure ulcer. We believe these risks should be discussed with family members before a decision is made to insert a feeding tube in a hospitalized nursing home resident with advanced cognitive impairment."

In the new study, Teno and her team asked two basic questions: "How does having a gastric feeding tube affect the chances of preventing a stage II or greater pressure ulcer?" and "Does having a gastric feeding tube help heal an existing pressure ulcer?"

Previous studies, which were much smaller in scope, had produced inconclusive findings. By using a combination of federally gathered data from nursing homes and Medicare claims, the researchers essentially mimicked a randomized controlled trial through the use of "propensity match cohort" study. Over a particular timeframe, they compared thousands of patients with and without ulcers who received a feeding tube to three times as many statistically similar patients with and without ulcers who did not get a tube.

The risk of feeding tubes

What they found was that among patients who did not start with an ulcer, 35.6 percent of those with a feeding tube ended up wi
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Contact: David Orenstein
david_orenstein@brown.edu
401-863-1862
Brown University
Source:Eurekalert  

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