School of Health and Welfare, Halmstad University, Halmstad, Sweden.
Regional Habilitation Center, Region Halland, Kungsbacka, Sweden.
Dev Med Child Neurol. 2020 Oct;62(10):1191-1197. doi: 10.1111/dmcn.14634. Epub 2020 Jul 22.
To describe trends in gastrostomy tube insertion in children with developmental or acquired disorders in Sweden and assess their demographic characteristics.
Children aged 0 to 18 years with gastrostomy tube insertions recorded between 1998 and 2014 were identified in the Swedish National Patient Register. Associations between disorder type and year of surgery, as well as age at surgery, were analysed using linear regression analyses. The association between disorder type and mortality 2 years from gastrostomy tube insertion was also analysed using logistic regression analysis.
The data for 4112 children (2182 males, 1930 females), with a median age of 2 years (interquartile range=1-8y), were analysed. Children who presented with developmental disorders were the largest group (n=3501, 85%). The most common diagnosis in children with developmental disorders was cerebral palsy (n=165, 4%). In children with acquired disorders, acute lymphoblastic leukaemia (n=117, 3%) was the most common diagnosis. Gastrostomy tube insertions increased from 1998 to 2014, with the greatest increase in children with developmental disorders, who were younger than children with acquired disorders when the gastrostomy tube was first inserted. Age at tube insertion decreased in both groups during the study period. Mortality was higher in children with acquired disorders, suggesting that gastrostomy tube insertion should be part of a palliative care approach.
Child characteristics differed depending on whether the underlying disorder was developmental or acquired, suggesting a need for clinical health care guidelines related to the specific goals of gastrostomy tube insertion.
Gastrostomy tube insertions increased by 140% from 1998 to 2014 in Sweden. The age of children with developmental disorders decreased by 1 month per year during the study period. Children presenting with developmental disorders were younger than children with acquired disorders when the gastrostomy tube was first inserted. Mortality was higher in children with acquired disorders.
描述在瑞典，患有发育或获得性障碍的儿童胃造口术管插入的趋势，并评估其人口统计学特征。
在瑞典国家患者登记处，确定了 1998 年至 2014 年间记录的年龄在 0 至 18 岁之间的接受胃造口术管插入术的儿童。使用线性回归分析，分析障碍类型与手术年份以及手术年龄之间的关系。还使用逻辑回归分析，分析障碍类型与胃造口术管插入后 2 年的死亡率之间的关系。
对 4112 名儿童（2182 名男性，1930 名女性）的数据进行了分析，他们的中位年龄为 2 岁（四分位间距=1-8y）。患有发育障碍的儿童是最大的群体（n=3501，85%）。发育障碍儿童最常见的诊断是脑瘫（n=165，4%）。获得性障碍儿童中，最常见的诊断是急性淋巴细胞白血病（n=117，3%）。从 1998 年到 2014 年，胃造口术管插入数量增加，患有发育障碍的儿童增加最多，他们在第一次插入胃造口术管时比患有获得性障碍的儿童年龄小。在研究期间，两组儿童的插入管年龄都有所下降。获得性障碍儿童的死亡率较高，这表明胃造口术管插入术应作为姑息治疗的一部分。
儿童的特征取决于潜在的障碍是发育性的还是获得性的，这表明需要制定与胃造口术管插入的具体目标相关的临床保健指南。
1998 年至 2014 年，瑞典的胃造口术管插入数量增加了 140%。在研究期间，患有发育障碍的儿童的年龄每年减少 1 个月。在第一次插入胃造口术管时，患有发育障碍的儿童比患有获得性障碍的儿童年龄小。获得性障碍儿童的死亡率较高。
