Hattori Yukari, Hamada Shota, Ishizaki Tatsuro, Sakata Nobuo, Iwagami Masao, Tamiya Nanako, Akishita Masahiro, Yamanaka Takashi
Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan.
Geriatr Gerontol Int. 2022 Aug;22(8):648-652. doi: 10.1111/ggi.14433. Epub 2022 Jul 5.
Previous studies have shown temporal trends in the number of gastrostomies until 2016, but the recent trend is yet to be analyzed. This study aimed to evaluate temporal trends in gastrostomy (mostly percutaneous endoscopic gastrostomy) in older adults in Japan in more recent years.
We extracted data on the numbers of gastrostomies and swallowing function assessment prior to gastrostomy, using the national aggregated open data (NDB Open Data) from 2014 to 2019.
Adults in their 80s accounted for the largest portion of gastrostomy during the study period. A decreasing trend in the total number of gastrostomy was observed in older adults from 2014 to 2016, but became almost stable thereafter (57 103 in 2014, 47 228 in 2016, and 47 944 in 2019). The age group-stratified numbers of gastrostomy per 100 000 individuals decreased by -33.9% (≥90 years group) to -6.1% (65-69 years group) from 2014 to 2019. The implementation rate of the swallowing function assessment remained relatively low, despite a slight increase (21.4% in 2015 to 23.7% in 2019).
We showed that the total number of gastrostomies remained almost stable after 2016 despite population aging. We considered that the avoidance of gastrostomy in frail or disabled older adults might explain the decrease, particularly for those aged over 80 years. Our findings would regain attention to appropriate decision-making for gastrostomy. Geriatr Gerontol Int 2022; 22: 648-652.
以往研究显示了截至2016年胃造口术数量的时间趋势，但近期趋势尚未得到分析。本研究旨在评估近年来日本老年人胃造口术（主要是经皮内镜下胃造口术）的时间趋势。
我们使用2014年至2019年的全国汇总开放数据（NDB开放数据），提取了胃造口术数量以及胃造口术前吞咽功能评估的数据。
在研究期间，80多岁的成年人占胃造口术的最大比例。2014年至2016年，老年人胃造口术总数呈下降趋势，但此后趋于稳定（2014年为57103例，2016年为47228例，2019年为47944例）。2014年至2019年，每10万人中按年龄组分层的胃造口术数量下降了-33.9%（≥90岁组）至-6.1%（65-69岁组）。尽管吞咽功能评估的实施率略有上升（从2015年的21.4%升至2019年的23.7%），但仍相对较低。
我们发现，尽管人口老龄化，但2016年后胃造口术总数基本保持稳定。我们认为，体弱或残疾老年人避免进行胃造口术可能是下降的原因，特别是对于80岁以上的老年人。我们的研究结果将重新引起人们对胃造口术适当决策的关注。《老年医学与老年病学国际杂志》2022年；22：648-652。
