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Titolo:
High short-term mortality in hospitalized patients with advanced dementia - Lack of benefit of tube feeding
Autore:
Meier, DE; Ahronheim, JC; Morris, J; Baskin-Lyons, S; Morrison, RS;
Indirizzi:
Mt Sinai Sch Med, Lilian & Benjamin Hertzberg Palliat Care Inst, Dept Geriatr & Adult Dev, New York, NY 10029 USA Mt Sinai Sch Med New York NY USA 10029 Adult Dev, New York, NY 10029 USA St Vincent Hosp & Med Ctr, Eileen E Anderson Sect Geriatr, New York, NY USA St Vincent Hosp & Med Ctr New York NY USA Sect Geriatr, New York, NY USA New York Med Coll, New York, NY 10029 USA New York Med Coll New York NY USA 10029 Med Coll, New York, NY 10029 USA
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 4, volume: 161, anno: 2001,
pagine: 594 - 599
SICI:
0003-9926(20010226)161:4<594:HSMIHP>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
HOME-ACQUIRED PNEUMONIA; PERCUTANEOUS ENDOSCOPIC GASTROSTOMY; TERMINALLY ILL PATIENTS; ALZHEIMERS-DISEASE; DECISION-MAKING; COGNITIVE IMPAIRMENT; FAMILY CAREGIVER; CARE; SURVIVAL; RESIDENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
56
Recensione:
Indirizzi per estratti:
Indirizzo: Meier, DE Mt Sinai Sch Med, Lilian & Benjamin Hertzberg Palliat Care Inst,Dept Geriatr & Adult Dev, Box 1070, New York, NY 10029 USA Mt Sinai Sch Med Box 1070 New York NY USA 10029 rk, NY 10029 USA
Citazione:
D.E. Meier et al., "High short-term mortality in hospitalized patients with advanced dementia - Lack of benefit of tube feeding", ARCH IN MED, 161(4), 2001, pp. 594-599

Abstract

Background: The influence of tube feeding on survival in hospitalized patients with advanced dementia is controversial. Objective: To assess long-term survival in an inception cohort, incident tube feeding placement during the index hospitalization, and the influence of tube feeding on survival in this group of patients. Subjects and Methods: Ninety-nine hospitalized patients with advanced dementia and an available surrogate decision maker were followed up through andafter the index hospitalization for mortality and placement of a feeding tube. Other variables measured included advance directive status, presence of a long-term primary care physician, level of involvement of the surrogatedecision maker, admitting diagnosis, prior hospitalizations, comorbidities, and diagnosis related group diagnostic category. Results: A new feeding tube was placed in 50% (51/99) of the study patients during the index hospitalization, 31% (31/99) left the hospital without afeeding tube, and 17% (17/99) were admitted with a feeding tube already inplace. By stepwise logistic regression analysis, predictors of new feedingtube placement included African American ethnicity (odds ratio, 9.43, 95% confidence interval, 2.1-43.2) and residence in a nursing home (odds ratio,4.9; 95% confidence interval, 1.02-2.5). Median survival of the 99 patients was 175 days. Eighty-five (85%) survived the index hospitalization, and 28 (28%) were still alive at last follow-up, a range of 1.3 to 4.2 years after enrollment in the study. Tube feeding was not associated with survival (P=.90). An admitting diagnosis of infection was associated with higher mortality (odds ratio, 1.9; 95% confidence interval, 1.01-3.6). Conclusions: In this cohort of hospitalized patients with advanced dementia, risk of receiving a new feeding tube is high, associated with African American ethnicity, and prior residence in a nursing home, and has no measurable influence on survival. With or without a feeding tube, these patients have a 50% six-month median mortality.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 12:18:53