Long-term nutrition management of gastrostomy patients within the secondary medical area network

Abstract

Purpose: The purpose of this study was to investigate the significance of long-term nutritional management of gastrostomy patients provided in the Numata secondary medical area, Gunma Prefecture.

Methods: Among patients managed by the regional alliance clinical pathways for gastrostomy we evaluated 1) prognosis after gastrostomy, 2) return-to-home rate, and 3) rate of transition from gastrostomy to oral feeding.

Results: A total of 371 patients (169 men, 202 women) were managed by the regional alliance clinical pathways for gastrostomy over a 7-year period starting from April 2012. Mean age at gastrostomy was 81.1 years. Analysis of 344 traceable patients revealed the following results. 1) Median survival time after gastrostomy was 619 days, the 1-month survival rate was 93.7%, the 1-year survival rate was 62.7%, the 3-year survival rate was 32%, and the 5-year survival rate was 19.5%. 2) Of the 99 surviving patients, 46 patients (46.5%) were in nursing homes, and the return-to-home rate was 17.2% (17 patients). 3) The rate of transition from gastrostomy to oral feeding was 4.2%.

Discussion and Conclusion: The prognosis of patients managed by the regional alliance clinical pathways for gastrostomy was good. Given the low return-to-home rate in this region, nutrition management with gastrostomy feeding is indispensable in nursing homes.