Ms Emily Farrugia1, Dr Liam Hannan1, Mr Mark Tacey1, Ms Shanelle Barba1
1Northern Health, Melbourne, Australia
Gastrostomy feeding represents a vital component of supportive care provided to individuals with Motor Neurone Disease (MND) and other disorders associated with swallowing or feeding difficulties. Maintaining stomal integrity and reducing risks of inadvertent tube dislodgement are crucial aspects of care, with many services recommending routine replacement every six months to minimise these risks. It is unknown whether individuals with MND are at excess risk of unplanned tube displacement.
This retrospective study aimed to examine the frequency of unplanned tube replacement and other gastrostomy tube complications in a mixed cohort of individuals managed by a single dietetic service at a metropolitan health service. Participants were included in the study on enrolment within the service and only complications related to Balloon Replacement Tubes (BRTs) were examined.
In total, the study examined 255 BRTs in n=53 individuals. Of these, n=15 (28.3%) had a diagnosis of MND, while the remaining n=38 (71.7%) had either stable (or slowly progressive) neurological disorders or malignancy as their indication for gastrostomy. Overall, n=89 of 255 (34.9%) BRTs required unplanned replacement (within six months) with compromised tube integrity one of the most frequent complications noted. Individuals with MND had n=15 of 42 unplanned replacements, representing a cumulative failure rate of 35.7% compared to 34.7% (p=0.96) in the remainder of the cohort. The possible influence of clinical factors other than diagnosis was also analysed.
BRTs required unplanned replacement within six months on less than 35% of occasions at a single metropolitan health service. Further analysis will assist in identifying possible options to mitigate the risks of unplanned displacement in future.
Emily Farrugia is an Accredited Practising Dietitian with a strong interest in research. Emily currently specialises in the area of Progressive Neurological Diseases, predominantly Motor Neurone Disease, at Northern Health in Victoria, which involves delivering patient care within a multidisciplinary team, developing community services, research and other quality improvement activities.