scholarly journals Racial and Socioeconomic Disparities in Gastrostomy Tube Placement After Intracerebral Hemorrhage in the United States

Stroke ◽  
2016 ◽  
Vol 47 (4) ◽  
pp. 964-970 ◽  
Author(s):  
Roland Faigle ◽  
Mona N. Bahouth ◽  
Victor C. Urrutia ◽  
Rebecca F. Gottesman
Keyword(s):  
United States ◽  
Intracerebral Hemorrhage ◽  
The United States ◽  
Gastrostomy Tube ◽  
Socioeconomic Disparities ◽  
Tube Placement ◽  
Gastrostomy Tube Placement

Variation in Gastrostomy Tube Placement in Premature Infants in the United States

2018 ◽  
Vol 36 (12) ◽  
pp. 1243-1249 ◽  
Author(s):  
Nathaniel H. Greene ◽  
Rachel G. Greenberg ◽  
Sean M. O'Brien ◽  
Alex R. Kemper ◽  
Marie Lynn Miranda ◽  
...  
Keyword(s):  
United States ◽  
Premature Infants ◽  
Gestational Age ◽  
The United States ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Adjusted Risk ◽  
Risk Estimates ◽  
Antenatal Steroids ◽  
Gastrostomy Tube Placement

Objective To describe the variation in surgical gastrostomy tube (SGT) placement in premature infants among neonatal intensive care units (NICUs) in the United States. Study Design We identified 8,781 premature infants discharged from 114 NICUs in the Pediatrix Medical Group from 2010 to 2012. The outcome of interest was SGT placement prior to discharge home from an NICU. Unadjusted proportions and adjusted risk estimates were calculated to quantify variation observed among individual NICUs. Results SGT placement occurred in 360 of 8,781 (4.1%) of infants. Across NICUs, any gastrostomy tube placement ranged from none in 45 NICUs up to 19.6%. Adjusted risk estimates for factors associated with SGT placement included gestational age at birth (odds ratio [OR]: 0.7/week, 95% confidence interval[CI]: [0.65, 0.75]), small for gestational age status (OR: 2.78 [2.09, 3.71]), administration of antenatal steroids (OR: 0.69 [0.52, 0.92]), Hispanic ethnicity (OR: 0.54 [0.37, 0.78]), and higher 5-minute Apgar scores (7–10, OR: 0.54 [0.37, 0.79]). Conclusion Individual NICU center has a strong clinical effect on the probability of SGT placement relative to other medical factors. Future work is needed to understand the cause of this variation and the degree to which it represents over or under use of gastrostomy tubes.

Mo1342 NATIONAL TRENDS IN ENDOSCOPIC AND NON-ENDOSCOPIC GASTROSTOMY TUBE PLACEMENT IN THE UNITED STATES

2019 ◽  
Vol 89 (6) ◽  
pp. AB499-AB500
Author(s):  
Muhammad H. Bashir ◽  
Tamta Chkhikvadze ◽  
Christine Chan ◽  
Nino Gigauri ◽  
Junxin Shi ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Gastrostomy Tube Placement ◽  
National Trends

Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals

2018 ◽  
Vol 27 (4) ◽  
pp. 978-987
Author(s):  
David Y. Hwang ◽  
Benjamin P. George ◽  
Adam G. Kelly ◽  
Eric B. Schneider ◽  
Kevin N. Sheth ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Gastrostomy Tube Placement

scholarly journals Novel Score Predicting Gastrostomy Tube Placement in Intracerebral Hemorrhage

Stroke ◽  
2015 ◽  
Vol 46 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Roland Faigle ◽  
Elisabeth B. Marsh ◽  
Rafael H. Llinas ◽  
Victor C. Urrutia ◽  
Rebecca F. Gottesman
Keyword(s):  
Intracerebral Hemorrhage ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Gastrostomy Tube Placement

Gastrostomy Tube Placement in Neonates Undergoing Congenital Heart Surgery: A Novel Assessment for Improving Utilization and Timing of Placement

2021 ◽  
Vol 12 (4) ◽  
pp. 480-486
Author(s):  
Kevin M. Beers ◽  
Aaron Bettenhausen ◽  
Thomas J. Prihoda ◽  
John H. Calhoon ◽  
S. Adil Husain
Keyword(s):  
Length Of Stay ◽  
Aortic Arch ◽  
Congenital Heart ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Genetic Syndrome ◽  
Delayed Sternal Closure ◽  
Aortic Arch Reconstruction ◽  
Gastrostomy Tube Placement ◽  
Arch Reconstruction

Background: Neonates undergoing congenital heart defect repair require optimized nutritional support in the perioperative period. Utilization of a gastrostomy tube is not infrequent, yet optimal timing for placement is ill-defined. The objective of this study was to identify characteristics of patients whose postoperative course included gastrostomy tube placement to facilitate supplemental tube feeding following neonatal repair of congenital heart defects. Methods: A single-institution, retrospective chart review identified 64 consecutive neonates who underwent cardiac operations from 2012 to 2016. Perioperative variables were evaluated for significance in relation to gastrostomy tube placement. Results: A total of 27 (42%) underwent gastrostomy tube placement. Diagnosis of a genetic syndrome was associated with the likelihood of placement of gastrostomy tube ( P = .032), as were patients with single ventricle physiology ( P = .0013) compared to those felt to be amenable to eventual biventricular repair. Aortic arch reconstruction ( P = .029), as well as the need for delayed sternal closure ( P = .05), was associated with increased frequency of gastrostomy tube placement. Postoperative outcomes including the number of days intubated ( P = .0026) and the presence of significant dysphagia ( P = .0034) were associated with gastrostomy placement. Additionally, genetic syndrome ( P = .003), aortic arch reconstruction ( P = .01), and postoperative intubation duration ( P = .0024) correlated with increased length of stay, where increased length of stay was associated with gastrostomy tube placement ( P = .0004). Discussion: Patient characteristics that were associated with a high likelihood of eventual gastrostomy placement were identified in this study. Early recognition of such characteristics in future patients may allow for reduced time to gastrostomy tube placement, which in turn may improve perioperative growth and outcomes.

Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement

2021 ◽  
pp. 000348942110157
Author(s):  
Jennifer L. McCoy ◽  
Ronak Dixit ◽  
R. Jun Lin ◽  
Michael A. Belsky ◽  
Amber D. Shaffer ◽  
...  
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Private Insurance ◽  
Chronic Otitis Media ◽  
The United States ◽  
Socioeconomic Disparities ◽  
Tube Placement ◽  
Median Income ◽  
Public Insurance ◽  
Tympanostomy Tubes

Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). Methods: A retrospective cohort study was performed at a tertiary children’s hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. Results: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance ( P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8, 95% CI: 1.2-2.5, P = .003). Conclusions: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. Level of Evidence: 4

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