TRENDS IN GASTROSTOMY USE AT THE END OF LIFE

通过胃造口术直接进入胃的管饲已经成为 一个普通的程序。 老年人胃造口安置率 美国人在1987年至1993年期间几乎翻了一番。这种增加 与新技术的引入相对应， 在没有全身麻醉的情况下放置永久性饲管。 这些 新的放置技术已经允许在医学上使用这些管 病人，尤其是年老体弱的病人。 的大约一半 接受胃造口术的患者在6个月内死亡。 我们建议 检查扩大使用胃造口的病人附近的 在国家卫生统计中心的两个点上， 从1986年和1998年这两年中每年随机抽取18,000名死者， 时间使用一个独特的数据集;国家死亡率跟踪调查 （NMFS）。 这份文件，可从1995年。 调查内容包括 死亡原因、人口统计学资料、接受的护理和 生命最后一年的功能状态。 这两项调查涵盖了 实施新的布局技术。 我们研究的 1986年调查并确定了足够数量的胃造口术手术： 175.这些人的平均年龄为73岁。 我们将分析这些 调查：确定接受治疗的患者的特征 1986年至1995年期间改变的胃造口术描述了卫生保健 接受胃造口术的老年人的利用情况 与接收相关的临床和人口统计学风险因素 通过病例对照研究， 我们预计，在20世纪90年代接受胃造口术的患者将 老年人，功能低下，更有可能有认知障碍。 这一分析将阐明这一技术在 老年人口。 更好地了解使用这种方法的模式， 技术在美国老年人中的应用可能为临床治疗提供新的策略。 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.