Predictive Factors for Preoperative Percutaneous Endoscopic Gastrostomy Placement
| Autor: | Munique Maia, Ashley R. Chandler, Jason Weissler, Raman R. Sharma, Armen K. Kasabian, Katie E. Weichman, Neil Tanna, Douglas Frank, Denis Knobel, Benjamin D. Smith |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Microsurgery medicine.medical_specialty Reconstructive surgery medicine.medical_treatment Coronary Artery Disease Sensitivity and Specificity Body Mass Index Diabetes Complications Coronary artery disease Pulmonary Disease Chronic Obstructive Enteral Nutrition Swallowing Predictive Value of Tests Percutaneous endoscopic gastrostomy Gastroscopy medicine Humans Prealbumin Prospective Studies Prospective cohort study Intubation Gastrointestinal Feeding tube Serum Albumin Aged Aged 80 and over Gastrostomy business.industry Smoking Age Factors General Medicine Middle Aged Plastic Surgery Procedures medicine.disease Deglutition Surgery Otorhinolaryngology Head and Neck Neoplasms Predictive value of tests business Forecasting |
| Zdroj: | Journal of Craniofacial Surgery. 26:2124-2127 |
| ISSN: | 1049-2275 |
| DOI: | 10.1097/scs.0000000000002132 |
| Popis: | OBJECTIVE The treatment of head and neck cancer has varying impact on postoperative recovery and return of swallowing function. The authors aim to establish screening tools to assist in preoperatively determining the need for gastrostomy tube placement. METHODS The authors prospectively assessed all patients undergoing complex head and neck reconstructive surgery during a 1-year study period. Only patients tolerating an oral diet, without preoperative gastrostomies, were enrolled for study. Eight parameters were assessed including: body mass index (BMI), prealbumin, albumin, smoking history, comorbidities [including coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM)], age, use of microvascular reconstruction, and type of defect. Two specific screening tools were assessed. In the first, a multivariate logistic regression model was employed to determine factor(s) that predict postoperative gastrostomy tube. In a second screening tool, the 8 parameters were scored between 0 to 1 points. The total score obtained for each patient was correlated with postoperative gastrostomy placement. RESULTS Out of the 60 study patients enrolled in the study, 24 patients (40%) received a postoperative gastrostomy. In the logistic regression model, albumin level was the only factor that was significantly associated with need for postoperative gastrostomy (P < 0.0023). A score of 4 or greater was determined to have a sensitivity of 83% and specificity of 61% for postoperative gastrostomy. CONCLUSIONS Patients with a score of 4 or more with this screening scoring system or those patients with an albumin level |
| Databáze: | OpenAIRE |
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