Transpyloric Tube Feeding for 506 Consecutive Patients with Delayed Gastric Emptying

小腸管灌營養治療於胃排空延遲的病患

林煊淮(Hsuan-Hwai Lin) ； 謝財源(Tsai-Yuan Hsieh) ； 朱恆成(Heng-Cheng Chu) ； 吳德敏(Der-Min Wu) ； 趙有誠(You-Chen Chao) ； 張維國(Wei-Kuo Chang)

《內科學誌》 17卷2期 (2006/04) Pp. 52-60

https://doi.org/10.6314/JIMT.2006.17(2).02

摘要

Purpose: Transpyloric tube feeding could provide early enteral nutrition; minimize cost; and reduce the risk of potential aspiration pneumonia to the patient with delayed gastric emptying. The aim of this study was to report the results of patients who received transpyloric tube feeding and to determine what kind of underlying disorders would get the most benefit from the transpyloric tube feeding. Methods: We retrospectively reviewed the patients who underwent transpyloric tube feeding from January 1996 through December 2001 at our hospital. Demographic characteristics, underlying disorders, base-line nutrition status, complications, hospital mortality, and durability of transpyloric tube feeding, daily caloric intake of 506 patients were obtained. Logistic regression analysis was used to compare the hospital mortality rate of patients who had different underlying disorders with adjustment for potentially confounding variables. Results: The patients mediate age was 73 years; 70.7% were male and 53.1% ICU patients. The most underlying disorders associated with delayed gastric emptying in these patients were infectious diseases in 211 (41.7%). There was a trend towards higher survival in those groups that could convert to nasogastric (NG) tube feeding or oral diet than the others (χ^2=125.9 p＜0.001). In subgroup analysis, neurological disorders group was associated with lower mortality rate (35.6%, p＜0.0l) and higher percentage switched to oral or NG feeding than other groups (60.0%, p＜0.0l). When adjusted for potentially confounding variables, neurological disorders group was associated with lower mortality rate compared with infectious disorders, diabetes mellitus, and malignancy of upper gastrointestinal tract (odds ratio: 2.39, 3.55, and 7.11; p=0.03, 0.01, and ＜0.01). Conclusions: Patients who have neurological disorders can get the most benefit from the transpyloric tube feeding.

並列摘要

Purpose: Transpyloric tube feeding could provide early enteral nutrition; minimize cost; and reduce the risk of potential aspiration pneumonia to the patient with delayed gastric emptying. The aim of this study was to report the results of patients who received transpyloric tube feeding and to determine what kind of underlying disorders would get the most benefit from the transpyloric tube feeding. Methods: We retrospectively reviewed the patients who underwent transpyloric tube feeding from January 1996 through December 2001 at our hospital. Demographic characteristics, underlying disorders, base-line nutrition status, complications, hospital mortality, and durability of transpyloric tube feeding, daily caloric intake of 506 patients were obtained. Logistic regression analysis was used to compare the hospital mortality rate of patients who had different underlying disorders with adjustment for potentially confounding variables. Results: The patients mediate age was 73 years; 70.7% were male and 53.1% ICU patients. The most underlying disorders associated with delayed gastric emptying in these patients were infectious diseases in 211 (41.7%). There was a trend towards higher survival in those groups that could convert to nasogastric (NG) tube feeding or oral diet than the others (χ^2=125.9 p＜0.001). In subgroup analysis, neurological disorders group was associated with lower mortality rate (35.6%, p＜0.0l) and higher percentage switched to oral or NG feeding than other groups (60.0%, p＜0.0l). When adjusted for potentially confounding variables, neurological disorders group was associated with lower mortality rate compared with infectious disorders, diabetes mellitus, and malignancy of upper gastrointestinal tract (odds ratio: 2.39, 3.55, and 7.11; p=0.03, 0.01, and ＜0.01). Conclusions: Patients who have neurological disorders can get the most benefit from the transpyloric tube feeding.

並列關鍵字

Transpyloric tube feeding ； Enteral nutrition ； Delayed gastric emptying ； Neurological disorders