Safety of Early Enteral Nutrition After Push and Pull Type Gastrostomy Tubes

Tuesday, March 7, 2023

3:09 PM – 3:18 PM

Location: Phoenix Convention Center, 222AB

Presenting Author(s)

Salman S. Shah, MD (he/him/his)

Chief, Division of Vascular & Interventional Radiology
Nassau University Medical Center

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

RA

Raiyan Ali, MS

Medical Student
New York Institute of Technology, College of Medicine
SB

Saif Baig, MD

Radiology Resident
Nassau University Medical Center

Disclosure(s):

Salman S. Shah, MD: No financial relationships to disclose

Purpose:

Assess the safety of early enteral nutrition initiation in patients who have undergone either push or pull type gastrostomy tube.

Materials and Methods:

IRB-approved, retrospective single-center study included 261 patients who underwent PEG or PRG from January 2018 to January 2022. 192 (73.56%) patients received early enteral nutrition (EEN) and 69 (26.44%) patients received delayed enteral nutrition (DEN). Most patients were white (n=111, 42.53%) and male (n=159, 60.92%) with median age 67 (interquartile range 45-89). Timing of feeding initiation was categorized into three different groups: immediate feeding (0-3 Hours), early feeding (3-6 Hours) and delayed feeding (12-24 Hours). Study participant characteristics (relevant comorbid conditions, active diagnoses) and outcomes (length of ICU stay, length of hospital stay and mortality) were recorded as a proportion of total population and by three categories of timing of feeding initiation.

Results:

Overall complication rate was 1.92%; one major bleeding case in EEN, one minor bleeding case in each group (DEN and EEN) and one feeding intolerance case in each group (DEN and EEN) (odds ratio – 0.5317; 95% CI - 0.0870-3.2517; p-value – 0.6101) . No complication occurred in immediate feeding-initiated group. No difference in complication rate was observed between EEN and DEN. DEN group was observed to have a longer length of stay in ICU and in hospital, though this was not statistically significant. The in-hospital mortality was greater in delayed feeding-initiated group (delayed feeding: n=15/69, 21.74% vs early feeding: n=30/192, 15.71%) although the difference was not statistically significant.

Conclusion: Similar low complications rates were seen between early feeds and delayed feeds in patients after gastrostomy tube placement. This suggests that EEN is probably safe.