Utility of three prognostic risk scores in predicting outcomes in elderly non-malignant patients after percutaneous gastrostomy

Background/Objectives Percutaneous endoscopic gastrostomy is a method of providing enteral feeding to patients who cannot take adequate oral nutrition. The aims of this study were to determine the performance of malnutrition and mortality scoring systems for predicting short and long-term mortality...

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Bibliographic Details
Published in:	The Journal of nutrition, health & aging Vol. 21; no. 10; pp. 1344 - 1348
Main Authors:	Kalkan, Ç., Kartal, A. Ç., Karakaya, F., Tüzün, A., Soykan, Irfan
Format:	Journal Article
Language:	English
Published:	Paris Springer Paris 01-12-2017 Springer Nature B.V
Subjects:	Aged Aged, 80 and over Aging Endoscopy Enteral Nutrition Female Gastrostomy Geriatrics Geriatrics/Gerontology Health risk assessment Humans Male Malnutrition Malnutrition - mortality Malnutrition - surgery Medical prognosis Medicine Medicine & Public Health Morbidity Mortality Neurosciences Nutrition Older people Ostomy Primary Care Medicine Prognosis Quality of Life Research Retrospective Studies Risk Sensitivity and Specificity Survival Analysis Treatment Outcome Turkey percutaneous endoscopic gastrostomy risk scoring system Mortality
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Summary:	Background/Objectives Percutaneous endoscopic gastrostomy is a method of providing enteral feeding to patients who cannot take adequate oral nutrition. The aims of this study were to determine the performance of malnutrition and mortality scoring systems for predicting short and long-term mortality in elderly patients who had undergone gastrostomy procedure due to non-malignant conditions. Design: Retrospective cohort study. Setting University hospital in Turkey. Participants 155 individuals aged 65 and older principally hospitalized for non-malignant diseases and require percutaneous endoscopic gastrostomy. Measurements “Geriatric Nutritional Risk Index”, “Malnutrition Universal Screening Tool” (MUST) and “Portsmouth- Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity” (P-POSSUM) scores were calculated. The ability of these scores to predict mortality was determined. Results The mean survival period was 9.59±6.0 months and mortality rate was 80.6%. The performance of “Geriatric Nutritional Risk Index” was superior to MUST and P-POSSUM in predicting long-term survival of gastrostomy patients; 94.1% of patients were alive with a cut-off value of 90 for “Geriatric Nutritional Risk Index” (sensitivity: 92% CI 85.9-95.6 and specificity: 90% CI 74.3-96.5). Survival analysis showed that patients (n=7) with a “Geriatric Nutritional Risk Index” score of > 98 before the gastrostomy had the longest survival time, while patients (n=102) with a “Geriatric Nutritional Risk Index” score of < 82 had the worst outcome. Conclusions A scoring system such as “Geriatric Nutritional Risk Index” should be considered as a risk scoring system for predicting early and late mortality at gastrostomy and also assist in making decisions such as timing of gastrostomy procedure.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1279-7707 1760-4788
DOI:	10.1007/s12603-016-0853-4