The association between gastrostomy tube placement, poor post-operative outcomes, and hospital re-admissions in head and neck cancer patients.

Published

Conference Paper

Investigate the relationship of G-tube placement timing on post-operative outcomes.908 patients underwent resection of head and neck upper aerodigestive tract tumors between 2007 and 2013. Patient charts were retrospectively screened for patient demographics, pre-operative nutrition variables, co-morbid conditions, Tumor-Node-Metastasis staging, surgical treatment type, and timing of G-tube placement. Exclusionary criteria included death within the first three months of the resection and resections performed solely for nodal disease.Post-surgical outcomes, including wound and medical complications, hospital re-admissions, length of inpatient hospital stay (LOS), intensive care unit (ICU) time.793 surgeries were included: 8% of patients had G-tubes pre-operatively and 25% had G-tubes placed post-operatively. Patients with G-tubes (pre-operative or post-operative) were more likely to have complications and prolonged hospital care as compared to those without G-tubes (p < 0.001). Patients with pre-operative G-tubes had shortened length of stay (p = 0.007), less weight loss (p = 0.03), and fewer wound care needs (p < 0.0001), when compared to those that received G-tubes post-operatively. Those with G-tubes placed post-operatively had worse outcomes in all categories, except pre-operative BMI.Though having enteral access in the form of a G-tube at any point suggests a more high risk patient, having a G-tube placed in the pre-operative period may protect against poor post-operative outcomes. Post-operative outcomes can be predicted based on patient characteristics available to the physician in the pre-operative period.

Full Text

Duke Authors

Cited Authors

  • Mays, AC; Worley, M; Ackall, F; D'Agostino, R; Waltonen, JD

Published Date

  • September 2015

Published In

Volume / Issue

  • 24 / 3

Start / End Page

  • 248 - 257

PubMed ID

  • 26321115

Pubmed Central ID

  • 26321115

Electronic International Standard Serial Number (EISSN)

  • 1879-3320

International Standard Serial Number (ISSN)

  • 0960-7404

Digital Object Identifier (DOI)

  • 10.1016/j.suronc.2015.08.005