TRENDS IN GASTROSTOMY USE AT THE END OF LIFE

通过胃造口直接送入胃的管子已经成为 这是一个常见的程序。老年人胃造口术安置率调查 美国人在1987至1993年间几乎翻了一番。这一增长 及时与新技术的引入相对应，允许 在没有全身麻醉的情况下放置永久性喂养管。这些 新的放置技术已经允许这些管在医学上的使用 病情较重的病人，尤其是虚弱的老年人。大约一半的人 行胃造口的患者在6个月内死亡。我们建议 检查胃造瘘术在胃造瘘口附近患者中的应用 在国家卫生统计中心的两个时间点结束生命，是 两年中每年18,000名死者的随机抽样：1986和 使用独特数据集的时间；全国死亡率回溯调查 (NMFS)。这份文件是从1995年开始提供的。这项调查包括 关于死因、人口统计、接受的护理和 生命最后一年的功能状态。这两项调查将 实施新的贴装技术。我们已经研究了 1986年进行了调查，并确定了足够数量的胃造口术： 175.这些人的平均年龄为73岁。我们将对这些进行分析 调查：确定接受治疗的患者的特征 1986年至1995年间胃造口术的变化描述了医疗保健 老年人胃造口术后的利用情况 与收据相关的临床和人口学风险因素 通过使用病例对照研究进行胃造口术。 我们预计90年代接受胃造口术的患者将是S 年龄较大，功能较差，更有可能有认知障碍。 这一分析将有助于该技术在 老年人口。提高了对此的使用模式的了解 美国老年人的技术可能会为临床提供新的策略 关于饲管的决策。

Tube feeding through a gastrostomy directly into the stomach has become a common procedure. Rates of gastrostomy placement among elderly Americans approximately doubled between 1987 and 1993. This increase corresponded in time to the introduction of new technology allowing the placement of permanent feeding tubes without general anesthesia. These new placement techniques have permitted use of these tubes in medically sicker patients, especially the frail elderly. Approximately half of patients receiving gastrostomy die within 6 months. We propose to examine the expanding utilization of gastrostomy among patients near the end of life at two points in National Center for Health Statistics, is a random sample of 18,000 decedents from each of two years: 1986 and time using a unique dataset; the National Mortality Followback Survey (NMFS). This file, available from the 1995. The survey includes information on cause of death, demographics, care received and functional status in the last year of life. The two surveys bracket the implementation of the new placement techniques. We have examined the 1986 survey and identified an adequate number of gastrostomy procedures: 175. The mean age of these individuals is 73. We will analyze these surveys to: identify how the characteristics of patients receiving gastrostomy changed between 1986 and 1995 describe the health care utilization of older adults who have received gastrostomy examine the clinical and demographic risk factors which are associated with receipt of a gastrostomy through use of case-control studies. We expect that patients receiving gastrostomy in the 1990's will be older, less functional and more likely to have a cognitive impairment. This analysis will shed light on expansion of this technology in the elderly population. Improved knowledge of patterns of use of this technology in older Americans may suggest new strategies for clinical decision-making about feeding tubes.