Association of nutritional support with survival-time in hospitalized older patients with dysphagia: a retrospective study

Annals of Nutrition and Metabolism

Human Nutrition: Letter

Free Access

Manabe T. · Masaki Y. · Yamamoto Y. · Yamamoto K. · Kohashi O. · Yamamoto T. · Ohara H. · Akatsu H.
Abstract

Dysphagia results from age-related changes in swallowing physiology and contributes to various health status changes, including higher risks for malnutrition, pneumonia, and mortality [1, 2]. It also occurs in age-related diseases, including stroke [3] and cancer [4], and progressive neurological diseases, such as dementia [5] and Parkinson’s disease [6]. These associations, and global aging, have increased the importance of dysphagia management. Artificial nutrition can support patients with dysphagia caused by various clinical conditions. Percutaneous endoscopic gastrostomy (PEG) is an artificial nutrition method that secures an enteral nutrition (EN) route in dysphagia patients [7]. PEG tubes have been widely used in Japan as a convenient and effective EN route since approximately 1990; however, the use of PEG feeding in dementia patients is controversial [8-10]. Total parenteral nutrition (TPN) is an alternative nutritional management method [11] and has been the most frequently used nutritional support method in Japan since 2010. A comparison of long-term outcomes associated with PEG feeding and TPN in older patients found that older patients, and those with poorer nutritional status and severe dementia, were more likely to receive TPN, whereas patients with cerebrovascular disease were more likely to receive PEG [12]. A 2012 Japan Geriatric Society position statement on end-of-life care for older adults suggested that patients’ families or caregivers should decide whether feeding tubes should be withheld or withdrawn [13]. Although advanced directives are now widely used, the decision of whether to institute enteral tube feeding is an important issue for older patients and their families. However, global clinical evidence for the effect of artificial nutritional support on survival-time, and for differences between administration routes, is lacking. The rate of aging in Japan is more rapid than in any other country, and more research is needed on clinical decision making for the older population. The study aim was to clarify the effects of artificial nutritional support route on survival-time of older terminal patients with dysphagia.

S. Karger AG, Basel

Article / Publication Details Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

留言 (0)

沒有登入
gif