Are Subacute Care Patients Living Longer?

In order to provide prognostic information for gerontologists who regularly counsel families, we determined to measure the longevity of subacute patients who have feeding tubes and tracheostomies. This study compares two cohorts of patients: 2002-2006 and 2015-2019. T-tests were performed to compare the total days in acute care, the total survival days, and the number of hospital admissions between the two groups. Results revealed (2002-2006, 2015-2019), some variance in the acute care days between the two groups (M= 15.4186, 21.49438) and p= .66. There is a wide difference in the total survival days between the two groups with individuals from 2015-2019 living longer than 2002-2006 (M= 229.8198, 644.0449), p< .001. However, there is no statistically significant difference in the number of hospital admissions between the two groups (M= 0.994186, 0.7752809), p= .09754. We hypothesize that advances in technology, medicine, and care over the span of 17 years contribute to increased longevity. On average, patients in the 2015-2019 group survived 414 days longer than the first group. Yet, even with such advances, more days were spent in acute care in the second group (2015-2019). Our data show subacute longevity has nearly tripled in the last decade. Although patients are living longer, they are often in a vegetative state; in most instances, there is no apparent improvement in quality of life. This study provides current data which will help gerontologists improve prognostication and allow them to form a more realistic long view of care.

P-OGC62 Home Enteral Tube Feeding: The Patient’s Perspective. Are we delivering an effective dietetic service?

Background Long term feeding tubes, managed independently at home have been shown to improve quality of life scores and in general are considered to be well tolerated. Beaumont Hospital has seen an increase in the number of patients referred for home enteral feeding (HEN) prior to neoadjuvant treatment for oesophagogastric (OG) cancer. We aimed to gain an insight into the supports, experiences and challenges encountered by these patients in an emerging service. Methods A retrospective qualitative study using data from 2019-2020. A questionnaire was adapted from a multicentre Irish study in 2017. Patients with OG cancer for treatment with curative intent, that underwent an elective feeding tube insertion for preoperative supplementary feeding were included. Patients were provided with a questionnaire via post. Data was analysed using Microsoft Excel. Results Response rate was 82% (14 of 17questionnaires). Mean age 60.4yrs (SD 11.7). 93% male (N = 13). In 36% (N = 5) tube feeding duration was < 3months and 3-6months duration in 43% (N = 6). Conclusions Overall positive feedback was received from patients regarding living with a feeding tube, confirming the important and impactful role of HEN. Priorities for service improvements: improved discharge information and resources may help reduce use of unreliable resources e.g. develop HEN discharge booklet to keep all relevant information in one accessible location, development of video education resources for consolidation of knowledge. Aim to provide more structured follow up with clear plans and channels of communication outlined for the patient. Quality improvement work with surgical team to reduce complication rate with feeding tubes.

The impact of different medical complications on the feasibility of removing the feeding tube from infants with dysphagia

PURPOSE: This study examined whether certain medical complications influence the feasibility of tube removal. METHODS: 42 subjects with dysphagia who were under the age of 2.5 years were nourished entirely through feeding tubes. Additionally, they were judged to have no aspiration. The following data about the infants were collected through a retroactive survey: age at which oral feeding training commenced, gender, and whether certain medical complications (cardiovascular, respiratory, digestive, neurological, or oral) had been present at birth. The data were analyzed to determine which type of medical complication affected the likelihood of removing the feeding tube from the infant at 3 years of age. RESULTS: Of the five medical complications examined, cardiovascular complications significantly affected the feasibility of tube removal (p = 0.049). CONCLUSION: Pediatric dysphagia patients with cardiac complications, compared to those with other complications, may take longer to transition off tube feeding.