A recent study (K Wong et al. J Pediatr 2018; 200: 188-95) examined a longitudinal cohort of 323 females in the Australian Rett Syndrome Study.
Key findings:
- 30.3% of the cohort underwent gastrostomy placement
- BMI was greater in individuals with gastrostomy placement
- Median age of gastrostomy placement was 9 years
- The all-cause mortality rate was greater in those who had gastrostomy placement compared with those who had not (hazard ratio 4.07, CI 1.96-8.45)
- Survival: 66.1% of the entire cohort was alive at 20 years of age (median survival was 33 years). The survival was 87.3% in those without a gastrostomy.
- Placement of a gastrostomy tube was not associated with fewer hospitalizations or improvement in parental physical or mental health
While the mortality was higher in those who received a gastrostomy tube, the study’s nonrandomized design does not allow definitive assessment of whether a gastrostomy tube is detrimental to long-term survival. Children who received gastrostomy tube may have had additional comorbidities.
My take: In adult medicine, it is generally accepted that Gtube placement does not prolong life (Clin Gastro & Hep 2007; 5: 1372). This study indicates that a Gtube may not improve longevity in many pediatric disorders as well.
Related blog posts:
- Which kids who aspirate need a gastrostomy tube?
- Long-term Outcomes with Pediatric PEG Placement
- Best Gastrostomy Tube
