Survival following the placement of gastrostomy tube in patients with multiple sclerosis

Mult Scler J Exp Transl Clin. 2020 Jan 14;6(1):2055217319900907. doi: 10.1177/2055217319900907. eCollection 2020 Jan-Mar.

Abstract

Background: Around a third of people with multiple sclerosis (MS) experience dysphagia. There is a need for disease-specific information on survival following placement of gastrostomy tube in people with MS.

Objective: We aimed to study survival following gastrostomy in patients with MS.

Methods: We reviewed medical records, home enteral feeding database and death certificates of people with MS who had gastrostomy from 2005 to 2017. Cox regression analysis was performed to identify independent predictors associated with mortality after gastrostomy.

Results: Median survival of 53 patients with MS after gastrostomy was 21.73 months. Median duration of hospital stay after gastrostomy was 14 days (IQR 5.25, 51.5). Survival at 30 days, 3 months, 1, 2, 5 and 10 years were 100% (53/53), 98.1% (52/53), 81.1% (43/53), 54.7% (29/53), 22.4% (11/49) and 6.8% (3/44), respectively. Of 53 patients, 24 died due to respiratory tract infection. Patients who had gastrostomy tube before 50 years of age survived longer (median 28.48 months) compared with those who had the gastrostomy after age 50 years (median 17.51 months) (p = 0.040).

Conclusion: Around 54% of patients with MS survived two or more years following gastrostomy. Younger patients had better survival. The most frequent cause of death was respiratory infection.

Keywords: Multiple sclerosis; deglutition disorders; dysphagia; enteral nutrition; gastrostomy; mortality; survival rate.