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Nutritional support teams increase percutaneous endoscopic gastrostomy uptake in motor neuron disease

World Journal of Gastroenterology 2012年第44期18卷 6461-6467页

作者： Lin Zhang leanne sanders Robert JL Fraser Nutrition and Dietetic Department Flinders Uni- versity of South Australia Bedford Park 5042 South Australia Australia Department of Nutrition and Dietetics Repa- triation General Hospital Daw Park 5041 South Australia Aus- tralia School of Medicine Flinders University of South Australia Bedford Park 5042 South Australia Australia

AIM:To examine factors influencing percutaneous endoscopic gastrostomy(PEG) uptake and outcomes in motor neuron disease(MND) in a tertiary care ***:Case notes from all patients with a confirmed diagnosis of MND who had attended the clinic at the Repatriation General Hospital between January 2007 and January 2011 and who had since died,were *** were extracted for demographics(age and gender),disease characteristics(date of onset,bulbar or peripheral predominance,complications),date and nature of discussion of gastrostomy insertion,nutritional status [weight measurements,body mass index(BMI)],date of gastrostomy insertion and subsequent progress(duration of survival) and quality of life(QoL) [Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised(ALSFRS-R)].In addition,the type of clinician initiating the discussion regarding gastrostomy was recorded as Nutritional Support Team(involved in providing nutrition input viz Gastroenterologist,Speech Pathologist,Dietitian) and other(involved in non-nutritional aspects of patient care).Factors affecting placement and outcomes including length of survival,change in weight and QoL were ***:Case records were available for all 86 patients(49 men,mean age at diagnosis 66.4 years).Thirty-eight patients had bulbar symptoms and 48 had peripheral disease as their presenting ***-six patients reported ***-one patients had undergone gastrostomy *** major indications for PEG placement were dysphagia and weight *** patients required immediate full feeding,whereas 17 patients initially used the gastrostomy to supplement oral intake,4 for medication administration and 1 for *** the PEG regime met 73% ± 31% of the estimated total energy requirements,increasing to 87% ± 32% prior to *** was stabilization of weight in patients undergoing gastrostomy [BMI at 3 mo(22.6 ± 2.2 kg/m 2) and 6 mo(22.5 ± 2.0 kg/m 2) after PEG placement compared to

关键词： Motor neuron disease Multidisciplinary ma-nagement Nutrition support team Percutaneous endo-scopic gastrostomy Survival

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