Tube feeding decreases pneumonia rate in patients with severe dementia: comparison between pre- and post-intervention

BMC Geriatrics

Research Article

Shintaro Takenoshita¹  Norihito Yamada¹  Seishi Terada¹  Keiichi Okazaki²  Akihiko Hirao³  Keiko Takayama⁴  Osamu Yokota⁵  Kengo Fujikawa⁵  Hiroyuki Asaba⁶  Hanae Nakashima-Yasuda⁷  Hiromi Takahashi⁷  Yasue Sakurada⁷  Keisuke Hirayama⁸  Keiko Kondo⁹  Kenji Nakata^1,10  Hideki Ishizu^1,11 

[1] Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, 700-8558, Okayama, Japan;Department of Psychiatry, Hayashi Hospital, Okayama, Japan;Department of Psychiatry, Kawada Hospital, Okayama, Japan;Department of Psychiatry, Kibogaoka Hospital, Tsuyama, Japan;Department of Psychiatry, Kinoko Espoir Hospital, Kasaoka, Japan;Department of Psychiatry, Kohnan Hospital, Tamano, Japan;Department of Psychiatry, Mannari Hospital, Okayama, Japan;Department of Psychiatry, Momonosato Hospital, Kasaoka, Japan;Department of Psychiatry, Sekizen Hospital, Tsuyama, Japan;Department of Psychiatry, Taiyo Hills Hospital, Takahashi, Japan;Department of Psychiatry, Zikei Hospital, Okayama, Japan;

关键词: Dementia;    Nasogastric tube;    Percutaneous endoscopic gastrostomy;    Pneumonia;    Tube feeding;   

DOI  :  10.1186/s12877-017-0662-6

 received in 2017-07-19, accepted in 2017-11-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIt 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.MethodsNine 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.ResultsWe 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.ConclusionsTF 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.

【 授权许可】

CC BY   
© The Author(s). 2017