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

th at least a stage II ulcer, while only 19.8 percent of patients without a feeding tube did. After statistical adjustment, they found that the chance of getting an ulcer was 2.27 times higher for people with feeding tubes than for those without. The risk of developing a more serious stage IV ulcer was 3.21 times higher for those with feeding tubes compared to hospitalized nursing home residents without a feeding tube.

Meanwhile, among patients who already had an ulcer, the researchers found that 27.1 percent of patients with a feeding tube saw short-term improvement, but 34.6 percent of those without a feeding tube experienced healing in a comparable timeframe. The adjusted odds of an ulcer getting better for people with a tube were 0.7 times as high for people without a tube, meaning their chances for improvement with a tube were less than for people without a tube.

The conventional wisdom among physicians three-quarters of them according to one study is that if anything, the nutrition delivered by feeding tubes should help patients resist ulcers. Perhaps with the idea of such a benefit in mind, physicians frequently don't discuss the risks of feeding tubes with patients' families, Teno has found.

The study did not measure how feeding tubes could cause ulcers, but Teno and her co-authors posit that because many patients become agitated by having a tube, they are often physically restrained and sedated with drugs. At the same time, feeding tubes can also increase the incidence of diarrhea. These circumstances, she said, may account for the development and worsening of pressure ulcers.

The new findings should lead doctors and families to ask more questions about whether feeding tubes are appropriate treatments, compared to careful hand feeding, for patients who have become so cognitively impaired that they can no longer eat independently, Teno said.

"To me this article is a game changer," Teno said. "It provides solid e
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Contact: David Orenstein
david_orenstein@brown.edu
401-863-1862
Brown University
Source:Eurekalert  

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