Division of Vascular and Interventional Radiology, Department of Radiology, University of Chicago, Chicago, USA.
Division of Vascular and Interventional Radiology, Department of Radiology, University of Arizona, Tuscon, Arizona, USA.
Diagn Interv Radiol. 2021 Jul;27(4):529-533. doi: 10.5152/dir.2021.20059.
We aimed to assess the association between complication rate and time to feeding in a cohort of patients undergoing radiologically guided placement of gastrostomy tubes.
A retrospective study was conducted of all patients receiving pull-type and push-type gastrostomy tubes placed by interventional radiologists between January 1st, 2017 and December 31st, 2018 at a single institution. Primary outcomes included procedural and tube-related complications per medical chart review with a follow-up interval of 30 days. Exclusion criteria were enteral nutrition delayed more than 48 hours, no feeding information, and tubes placed for venting (n=20). Overall, 303 gastrostomy tubes (pull-type, n=184; push-type, n=119) were included. The most common indications for placement included head and neck carcinoma for push-type tubes (n=76, 63.9%) and cerebral vascular accident for pull-type tubes (n=78, 42.4%).
In a multiple regression analysis, there was no statistically significant association between complications and time to feeding (p = 0.096), age (p = 0.758), gender (p = 0.127), indication for tube placement (p = 0.206), or type of tube placed (p = 0.437). Average time to initiation of enteral nutrition was 12.3 hours for the pull-type and 21.7 hours for the push-type cohort (p < 0.001). Additional multiple regression analyses of pull-type tubes and push-type tubes separately also did not find any significant association between complications and the above factors (p > 0.05).
There was no statistically significant correlation between time to feed and complications, suggesting that there is no clinical difference between early and late feeding following gastrostomy tube placement.
我们旨在评估在接受放射引导胃造口管放置的患者队列中,并发症发生率与喂养开始时间之间的关系。
对 2017 年 1 月 1 日至 2018 年 12 月 31 日期间,在一家机构中接受介入放射科医生放置的拉式和推式胃造口管的所有患者进行回顾性研究。主要结果包括根据病历回顾的手术和管相关并发症,随访间隔为 30 天。排除标准为肠内营养延迟超过 48 小时、无喂养信息和放置用于通气的管(n=20)。共有 303 个胃造口管(拉式,n=184;推式,n=119)纳入研究。放置的最常见指征包括推式管的头颈部癌(n=76,63.9%)和拉式管的脑血管意外(n=78,42.4%)。
在多元回归分析中,并发症与喂养开始时间之间无统计学显著关联(p=0.096),与年龄(p=0.758)、性别(p=0.127)、管放置指征(p=0.206)或管类型(p=0.437)也无统计学显著关联。拉式组和推式组开始肠内营养的平均时间分别为 12.3 小时和 21.7 小时(p<0.001)。对拉式管和推式管分别进行的进一步多元回归分析也未发现并发症与上述因素之间存在任何显著关联(p>0.05)。
喂养开始时间与并发症之间无统计学显著相关性,表明胃造口管放置后早期和晚期喂养之间无临床差异。