IngentaConnect Nutritional Status and Quality of Life in Patients with Percutane...

Authors: Klose J.¹; Heldwein W.¹; Rafferzeder M.¹; Sernetz F.¹; Gross M.¹; Loeschke K.¹

Source: Digestive Diseases and Sciences, Volume 48, Number 10, October 2003 , pp. 2057-2063(7)

Publisher: Springer

Abstract:

Sixty patients (age 73 ± 14 years; 22 women, 38 men) with dysphagia (67% neurological diseases, 33% tumors) were followed up for 1 year after placement of a percutaneous endoscopic gastrostomy (PEG). Before PEG placement and at six appointments thereafter, the patients' nutritional status was measured using bioelectric impedance analysis (BIA) and hematological nutritional parameters. A validated questionnaire was used to assess quality of life (the Gastrointestinal Quality of Life Index, GIQLI). The overall mortality rate was 65%, and mortality during the hospitalization period was 22%. Depending on the duration of the dysphagia, marked nutritional deficits were observed at the start of the study (deficiencies in albumin in 49% of the patients, calcium in 15%, magnesium in 18%, retinol in 78%, alpha

-tocopherol in 16%, folic acid in 16%, vitamin B₁₂ in 8%, vitamin D in 40%, and zinc in 46%). With the exception of vitamin E, all parameters returned to normal during the follow-up period. At the start of the study, BIA indicated nutritional deficiency in 90% of the patients, with no overall improvement being observed during the follow-up period. The GIQLI scores, on average, reached a figure of 61% of an unrestricted quality of life. In conclusion, long-term nutrition via the PEG tube maintained the patients' quality of life. For BIA most patients were malnourished during the follow-up period, but nevertheless PEG feeding was enough to compensate for gross nutritional deficiencies. Not infrequently, the indication for PEG placement is established too late.

Keywords: enteral nutrition; gastrostomy; nutrition; percutaneous endoscopic gastrostomy; tube feeding

Document Type: Research article

Affiliations: 1: The Ludwig Maximilian University, Munich. Department of Medicine, City Center Hospital, Munich, Germany

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Nutritional Status and Quality of Life in Patients with Percutaneous Endoscopic Gastrostomy (PEG) in Practice: Prospective One-Year Follow-Up