TY - JOUR
T1 - Tube feeding decreases pneumonia rate in patients with severe dementia
T2 - Comparison between pre- and post-intervention
AU - Takenoshita, Shintaro
AU - Kondo, Keiko
AU - Okazaki, Keiichi
AU - Hirao, Akihiko
AU - Takayama, Keiko
AU - Hirayama, Keisuke
AU - Asaba, Hiroyuki
AU - Nakata, Kenji
AU - Ishizu, Hideki
AU - Takahashi, Hiromi
AU - Nakashima-Yasuda, Hanae
AU - Sakurada, Yasue
AU - Fujikawa, Kengo
AU - Yokota, Osamu
AU - Yamada, Norihito
AU - Terada, Seishi
N1 - Funding Information:
Data collection was supported by JSPS KAKENHI Grant Number 15 K09831 and 16 K10251. Writing and publication of this manuscript were supported by a research grant from the Zikei Institute of Psychiatry. The funders had no role in study design, data analysis, or decision to publish.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/11/21
Y1 - 2017/11/21
N2 - Background: It is widely supposed that there is no benefit, including extended survival and decreased rate of pneumonia, in patients with severe dementia receiving enteral tube feeding (TF). However, there have been few studies comparing the frequency of pneumonia before and after TF in severe dementia. Methods: Nine psychiatric hospitals in Okayama Prefecture participated in this retrospective survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty in oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition, and they decided whether or not to make use of long-term artificial nutrition from January 1, 2014 to December 31, 2014. Results: We evaluated 58 patients including 46 with TF and 12 without. The mean age of all patients was 79.6 ± 9.0 years old. Patients with probable Alzheimer's disease (n = 38) formed the biggest group, and those with vascular dementia the second (n = 14). Median survival times were 23 months among patients with TF and two months among patients without TF. The start of TF decreased the frequency of pneumonia and the use of intravenous antibiotics. Conclusions: TF decreased pneumonia and antibiotic use, even in patients with severe dementia. The results of this study do not necessarily indicate that we should administer TF to patients with severe dementia. We should consider the quality of life of patients carefully before deciding the use or disuse of TF for patients with severe dementia.
AB - Background: It is widely supposed that there is no benefit, including extended survival and decreased rate of pneumonia, in patients with severe dementia receiving enteral tube feeding (TF). However, there have been few studies comparing the frequency of pneumonia before and after TF in severe dementia. Methods: Nine psychiatric hospitals in Okayama Prefecture participated in this retrospective survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty in oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition, and they decided whether or not to make use of long-term artificial nutrition from January 1, 2014 to December 31, 2014. Results: We evaluated 58 patients including 46 with TF and 12 without. The mean age of all patients was 79.6 ± 9.0 years old. Patients with probable Alzheimer's disease (n = 38) formed the biggest group, and those with vascular dementia the second (n = 14). Median survival times were 23 months among patients with TF and two months among patients without TF. The start of TF decreased the frequency of pneumonia and the use of intravenous antibiotics. Conclusions: TF decreased pneumonia and antibiotic use, even in patients with severe dementia. The results of this study do not necessarily indicate that we should administer TF to patients with severe dementia. We should consider the quality of life of patients carefully before deciding the use or disuse of TF for patients with severe dementia.
KW - Dementia
KW - Nasogastric tube
KW - Percutaneous endoscopic gastrostomy
KW - Pneumonia
KW - Tube feeding
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U2 - 10.1186/s12877-017-0662-6
DO - 10.1186/s12877-017-0662-6
M3 - Article
C2 - 29157223
AN - SCOPUS:85034669562
VL - 17
JO - BMC Geriatrics
JF - BMC Geriatrics
SN - 1471-2318
IS - 1
M1 - 267
ER -