scholarly journals Association between teeth loss and nasogastric tube feeding dependency in older adults from Taiwan: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chun-Chieh Wang ◽  
Yu-Yen Chen ◽  
Kuo-Chuan Hung ◽  
Shang-Jung Wu ◽  
Yung-Feng Yen ◽  
...  
Keyword(s):  
Older Adults ◽  
National Health ◽  
Nasogastric Tube ◽  
Tube Feeding ◽  
Nasogastric Feeding ◽  
Number Of Teeth ◽  
Increased Risk ◽  
The Mean ◽  
Nasogastric Tube Feeding

Abstract Background To examine the association between teeth loss and nasogastric tube feeding dependency in older people. Methods The National Health Interview Survey (NHIS) 2005, 2009, and 2013 in Taiwan. Participants were selected by a multistage stratified sampling method and baseline characteristics, including socioeconomic status and health habits, were obtained by well-trained interviewers. The NHIS was linked with the National Health Insurance research database 2000–2016 and the National Deaths Dataset, which contains all the medical information of ambulatory and inpatient care. Cox regression was used to examine the association between the number of teeth lost and nasogastric tube feeding dependency. Results There were 6165 adults older than 65 years old enrolled in the analysis, with 2959 male (48%) and the mean (SD) age was 73.95(6.46) years old. The mean follow-up duration was 6.5(3.3) years. Regarding the teeth loss categories, 1660 (26.93%), 2123 (34.44%), and 2382 (38.64%) of participants were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. During 39,962 person-years of follow-up, new-onset nasogastric feeding dependency was recognized in 220(13.25%), 256(12.06%), and 461(19.35%) participants who were categorized as having no teeth loss, loss of 1–9 teeth, and loss of 10–28 teeth, respectively. Kaplan-Meier curves demonstrated significant findings (Log-rank P < 0.01). After potential confounders were adjusted, compared with those without teeth loss, older adults who had lost 10–28 teeth had significantly increased risks of occurrence nasogastric feeding dependency (AHR, 1.31; 95% CI, 1.05–1.62; p-value = 0.02). Furthermore, a significant dose-response relation between the number of teeth lost and increased risk of nasogastric feeding was found (p for trend< 0.01). Conclusions Older adults who had lost 10–28 teeth had a significantly increased risk of nasogastric tube feeding dependency. Early identification of the oral disease is crucial for the prevention of the occurrence of teeth loss and the following nutrition problems, which would reduce risk of nasogastric tube feeding dependency.

scholarly journals Nasogastric tube feeding versus assisted hand feeding in-home healthcare older adults with severe dementia in Taiwan: a prognosis comparison

2020 ◽  
Author(s):  
Hsiao-Hui Chou ◽  
Meng-Ting Tsou ◽  
Lee-Ching Hwang
Keyword(s):  
Nasogastric Tube ◽  
Older Patients ◽  
Tube Feeding ◽  
Mortality Rates ◽  
Home Healthcare ◽  
Severe Dementia ◽  
Clinical Prognosis ◽  
Increased Risk ◽  
Significant Difference ◽  
Nasogastric Tube Feeding

Abstract Backgrounds: All individuals with severe dementia should be offered careful hand feeding. However, under certain circumstances, people with severe dementia have a feeding tube placed. In Taiwan, tube feeding rate in demented older home care residents is increasing；however, the benefits of tube feeding in this population remain unknown. We compared the clinical prognosis and mortality of older patients with severe dementia receiving nasogastric tube feeding (NGF) or assisted hand feeding (AHF). Methods: This retrospective longitudinal study enrolled 169 participants over 60 years of age in the setting of in-home healthcare between January 1 and December 31, 2017. All subjects with documented severe dementia and complete functional dependence suffered from difficulty in oral intake and required either AHF or NGF. Data were collected from both groups to analyze pneumonia, hospitalization, and mortality rates. Results: A total of 169 subjects (56 males and 113 females, aged 85.9 ± 7.5 years) were analyzed. Of note, 39 required AHF and 130 NGF. All subjects were bedridden; 129 (76%) showed Barthel index < 10. Pneumonia risk was higher in the NGF group (48%) than in the AHF group (26%, p = 0.015). After adjusting for multiple factors in the regression model, the risk of pneumonia was not significantly higher in older subjects belonging to the NGF group compared to the AHF group. One-year mortality rates in the AHF and NGF groups were 8% and 15%, respectively, and no significant difference was observed after adjustment with logistic regression (aOR = 2.38; 95% CI, 0.58–9.70). There were no significant differences in hospitalization rate and duration. Conclusions: For older patients with dementia requiring in-home healthcare, NGF is not associated with a significantly lower risk of pneumonia than AHF. Additionally, neither mortality nor hospitalization rates decreased with NGF. On the contrary, a non-significant trend of increased risk of pneumonia was observed in NGF group. Therefore, the benefits of NGF are debatable in older patients with severe dementia requiring in-home healthcare. Continued careful hand feeding could be an alternative to NG feeding in patients with severe dementia. Furthermore, large-scale studies on home healthcare would be required to support these results.

scholarly journals Nasogastric Tube Feeding in Older Patients: A Review of Current Practice and Challenges Faced

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Devkishan Chauhan ◽  
Surabhi Varma ◽  
Melanie Dani ◽  
Michael B. Fertleman ◽  
Louis J. Koizia
Keyword(s):  
Enteral Nutrition ◽  
Nasogastric Tube ◽  
Older Patients ◽  
Current Practice ◽  
Tube Feeding ◽  
Oral Route ◽  
Tube Placement ◽  
Nasogastric Feeding ◽  
National Patient ◽  
Nasogastric Tube Feeding

Nasogastric tube feeding is an essential way of delivering enteral nutrition when the oral route is insufficient or unsafe. Malnutrition is recognised as a reversible factor for sarcopenia and frailty. It is therefore crucial that malnutrition is treated in older inpatients who have dysphagia and require enteral nutrition. Despite five National Patient Safety Alerts since 2005, “Never Events” related to nasogastric feeding persist. In addition to placement errors, current practice often leads to delays in feeding, which subsequently result in worse patient outcomes. It is crucial that tube placement is confirmed accurately and in a timely way. Medical advancements in this area have been slow to find a solution which meets this need. In this paper, we provide an updated review on the current use of feeding nasogastric tubes in the older population, the issues associated with confirming correct placement, and innovative solutions for improving safety and outcomes in older patients.

Obligate Nasal Breathing in an Elderly Woman: Increased Risk of Nasogastric Tube Feeding

1988 ◽  
Vol 12 (5) ◽  
pp. 531-532 ◽  
Author(s):  
Oscar G. Hernandez ◽  
Steve Nelson ◽  
Edward F. Haponik ◽  
Alfredo Lopez ◽  
Warren Summer
Keyword(s):  
Nasogastric Tube ◽  
Elderly Woman ◽  
Tube Feeding ◽  
Nasal Breathing ◽  
Increased Risk ◽  
Nasogastric Tube Feeding

scholarly journals Case Report: Acute Submandibular Glanditis Caused by Nasogastric Tube Feeding in A Subject with Poorly Controlled Diabetes Mellitus

2021 ◽  
Author(s):  
Yuichiro Iwamoto ◽  
Takatoshi Anno ◽  
Katsumasa Koyama ◽  
Koichi Tomoda ◽  
Tomohiko Kimura ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Parenteral Nutrition ◽  
Submandibular Gland ◽  
Nasogastric Tube ◽  
Artery Bypass ◽  
Tube Feeding ◽  
Coronary Intervention ◽  
Increased Risk ◽  
Nasogastric Tube Feeding

Abstract Background Enteral tube feeding is an effective method of providing nutrients for patients who are unable to meet their nutritional requirements and patients with parenteral nutrition are possible the increased risk of infection. The submandibular gland is one of the salivary glands and some of sialadenitis are caused by obstruction of the salivary outflow tract. Case presentation A 91-year-old woman had parenteral nutrition with nasogastric tube feeding. Her background history was repeated angina and myocardial infarction and performed percutaneous coronary intervention and coronary artery bypass grafting, type 2 diabetes (T2DM), heart failure, atrial fibrillation and sick sinus syndrome and performed, pacemaker placement. She was continued parenteral nutrition with nasogastric tube feeding for 20 days, and suddenly she had high fever and elevated infection markers under poorly glycemic control. We diagnosed her as acute submandibular glanditis. We treated her with antibiotics therapy, extubation, daily massage of the submandibular gland and strict glycemic control, and her neck swelling disappeared about 11 days after such treatment. Conclusions We reported acute submandibular glanditis induced by nasogastric tube feeding under poorly controlled diabetes mellitus. We have to pay attention to glycemic control in subjects under parenteral nutrition with tube feeding management.

scholarly journals Nasogastric tube feeding versus assisted hand feeding in-home healthcare older adults with severe dementia in Taiwan: a prognosis comparison

2020 ◽  
Author(s):  
Hsiao-Hui Chou ◽  
Meng-Ting Tsou ◽  
Lee-Ching Hwang
Keyword(s):  
Nasogastric Tube ◽  
Older Patients ◽  
Tube Feeding ◽  
Mortality Rates ◽  
Home Healthcare ◽  
Severe Dementia ◽  
Clinical Prognosis ◽  
Increased Risk ◽  
Significant Difference ◽  
Nasogastric Tube Feeding

Abstract Background: All individuals with severe dementia should be offered careful hand feeding. However, under certain circumstances, people with severe dementia have a feeding tube placed. In Taiwan, tube feeding rate in demented older home care residents is increasing；however, the benefits of tube feeding in this population remain unknown. We compared the clinical prognosis and mortality of older patients with severe dementia receiving nasogastric tube feeding (NGF) or assisted hand feeding (AHF). Methods: Data from the in-home healthcare system between January 1 and December 31, 2017 were analyzed to identify 169 participants over 60 years of age in this retrospective longitudinal study. All subjects with severe dementia and complete functional dependence suffered from difficulty in oral intake and required either AHF or NGF. Data were collected from both groups to analyze pneumonia, hospitalization, and mortality rates. Results: A total of 169 subjects (56 males and 113 females, aged 85.9 ± 7.5 years) were analyzed. 39 required AHF and 130 NGF. All subjects were bedridden; 129 (76%) showed Barthel index < 10. Pneumonia risk was higher in the NGF group (48%) than in the AHF group (26%, p = 0.015). After adjusting for multiple factors in the regression model, the risk of pneumonia was not significantly higher in the NGF group compared with the AHF group. One-year mortality rates in the AHF and NGF groups were 8% and 15%, respectively, and no significant difference was observed after adjustment with logistic regression (aOR = 2.38; 95% CI, 0.58–9.70). There were no significant differences in hospitalization rate and duration. Conclusions: For older patients with dementia requiring in-home healthcare, NGF is not associated with a significantly lower risk of pneumonia than AHF. Additionally, neither mortality nor hospitalization rates decreased with NGF. On the contrary, a nonsignificant trend of increased risk of pneumonia was observed in NGF group. Therefore, the benefits of NGF are debatable in older patients with severe dementia requiring in-home healthcare. Continued careful hand feeding could be an alternative to NG feeding in patients with severe dementia. Furthermore, large-scale studies on in-home healthcare would be required to support these results.

scholarly journals Sluder's neuralgia- A sequalae of nasogastric tube feeding

2020 ◽  
Author(s):  
Joshna Naidu ◽  
Anand Subash ◽  
Vishal Rao
Keyword(s):  
Nasogastric Tube ◽  
Tube Feeding ◽  
Well Being ◽  
Nasogastric Feeding ◽  
Unilateral Headache ◽  
Nutritional Needs ◽  
Physical Comfort ◽  
A Prospective Study ◽  
Persistent Headache ◽  
Nasogastric Tube Feeding

Management of nutritional needs is of paramount importance in cancer patients and nasogastric feeding is the most common method. Nasal cavity being a richly innervated region, is also a hallway for the exposure of the same to external environment. Any trauma or pressure to these nerve endings result in unilateral headache mimicking Sluder’s neuralgia. Nasogastric tube may irritate the nasal mucosa and exert pressure on the nasal turbinates. We believe that the persistent headache in patients with NG tube is distinctly significant that it interferes with the physical comfort of patient. It also influences the sleep patterns, thereby causing repercussions in the emotional well-being. Head and neck oncologists being the primary clinicians, it is imperative to consider the Sluder’s neuralgia in patients with nasogastric tube feeding. This mandates a prospective study to describe the clinical features and the treatment of ‘NGT neuralgia’.

scholarly journals Evaluation of early feeding through nasogastric tube in patients after cardiovascular surgery at the Hanoi Heart Hospital

2021 ◽  
Vol 35 ◽  
pp. 34-41
Author(s):  
Nguyen Thi Hue ◽  
Le Van Hieu
Keyword(s):  
Vascular Surgery ◽  
Nasogastric Tube ◽  
Cardiovascular Surgery ◽  
Tube Feeding ◽  
Abdominal Distension ◽  
Early Feeding ◽  
The Mean ◽  
Cardio Vascular ◽  
Nasogastric Tube Feeding ◽  
Heart Hospital

Objectives: The goal of the study was to describle and understand the factors related to the nasogastric tube feeding in patients after cardio-vascular surgery. Methods: The study involved 100 consecutive patients who underwent cardio-vascular surgery at Hanoi Heart Hospital from April 1 to August 3, 2019..All subjects underwent assessed with the early feeding through nasogastric tube after 6 hours operation. Main results: The mean age of the patients was 54.4 ± 14.5 years old. The percentage of men were 48%, BMI <18.5 were 25%, used inotropic drug were 46% and sedative were 27%. The incidence of patients with abdominal distension and vomiting were 13%. No complications related to early feeding. Factors related to the residual index were sedation and duration of mechanical ventilation. Conclusion: Early nasogastric tube feeding in patients after cardiac and vascular surgery is safe, feasible and feasible.

scholarly journals Gastrostomy versus nasogastric tube feeding for chemoradiation patients with head and neck cancer: the TUBE pilot RCT

2018 ◽  
Vol 22 (16) ◽  
pp. 1-144 ◽  
Author(s):  
Vinidh Paleri ◽  
Joanne Patterson ◽  
Nikki Rousseau ◽  
Eoin Moloney ◽  
Dawn Craig ◽  
...  
Keyword(s):  
Nasogastric Tube ◽  
Economic Value ◽  
Tube Feeding ◽  
Cost Effective ◽  
Recruitment Rate ◽  
Oral Feeding ◽  
Information Analysis ◽  
Pre Treatment ◽  
Nasogastric Tube Feeding

Background Approximately 9000 new cases of head and neck squamous cell cancers (HNSCCs) are treated by the NHS each year. Chemoradiation therapy (CRT) is a commonly used treatment for advanced HNSCC. Approximately 90% of patients undergoing CRT require nutritional support via gastrostomy or nasogastric tube feeding. Long-term dysphagia following CRT is a primary concern for patients. The effect of enteral feeding routes on swallowing function is not well understood, and the two feeding methods have, to date (at the time of writing), not been compared. The aim of this pilot randomised controlled trial (RCT) was to compare these two options. Methods This was a mixed-methods multicentre study to establish the feasibility of a RCT comparing oral feeding plus pre-treatment gastrostomy with oral feeding plus as-required nasogastric tube feeding in patients with HNSCC. Patients were recruited from four tertiary centres treating cancer and randomised to the two arms of the study (using a 1 : 1 ratio). The eligibility criteria were patients with advanced-staged HNSCC who were suitable for primary CRT with curative intent and who presented with no swallowing problems. Main outcome measures The primary outcome was the willingness to be randomised. A qualitative process evaluation was conducted alongside an economic modelling exercise. The criteria for progression to a Phase III trial were based on a hypothesised recruitment rate of at least 50%, collection of outcome measures in at least 80% of those recruited and an economic value-of-information analysis for cost-effectiveness. Results Of the 75 patients approached about the trial, only 17 consented to be randomised [0.23, 95% confidence interval (CI) 0.13 to 0.32]. Among those who were randomised, the compliance rate was high (0.94, 95% CI 0.83 to 1.05). Retention rates were high at completion of treatment (0.94, 95% CI 0.83 to 1.05), at the 3-month follow-up (0.88, 95% CI 0.73 to 1.04) and at the 6-month follow-up (0.88, 95% CI 0.73 to 1.04). No serious adverse events were recorded in relation to the trial. The qualitative substudy identified several factors that had an impact on recruitment, many of which are amenable to change. These included organisational factors, changing cancer treatments and patient and clinician preferences. A key reason for the differential recruitment between sites was the degree to which the multidisciplinary team gave a consistent demonstration of equipoise at all patient interactions at which supplementary feeding was discussed. An exploratory economic model generated from published evidence and expert opinion suggests that, over the 6-month model time horizon, pre-treatment gastrostomy tube feeding is not a cost-effective option, although this should be interpreted with caution and we recommend that this should not form the basis for policy. The economic value-of-information analysis indicates that additional research to eliminate uncertainty around model parameters is highly likely to be cost-effective. Study limitations The recruitment issues identified for this cohort may not be applicable to other populations undergoing CRT. There remains substantial uncertainty in the economic evaluation. Conclusions The trial did not meet one of the three criteria for progression, as the recruitment rate was lower than hypothesised. Once patients were recruited to the trial, compliance and retention in the trial were both high. The implementation of organisational and operational measures can increase the numbers recruited. The economic analysis suggests that further research in this area is likely to be cost-effective. Future work The implementation of organisational and operational measures can increase recruitment. The appropriate research question and design of a future study needs to be identified. More work is needed to understand the experiences of nasogastric tube feeding in patients undergoing CRT. Trial registration Current Controlled Trials ISRCTN48569216. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 16. See the NIHR Journals Library website for further project information.

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