Complications with gastrostomy by intellectually disabled persons in the Netherlands
Aard en omvang van complicaties van gastrostomata bij ernstig meervoudig gehandicapten
26 May 2012, PDF |
33 pages |
van Tienhoven EAE, Hilbers ESM, van Halteren AR
RIVM Report 318902014
Gastrostomy is a procedure that involves placing a tube into a person's stomach through the abdominal wall to provide long-term nutritional support. While the procedure increases the quality of life, it is also associated with several complications. A survey among members of the Netherlands Society of Physicians for Persons with Intellectual Disabilities (NVAVG) has been performed to identify the incidence and nature of the complications in intellectually disabled persons in the Netherlands. A total of 77 questionnaires were completed, representing about one-third of all the questionnaires sent out. Eighty per cent of the respondent physicians who work with severely intellectually disabled persons had to deal with complications in the last five years. Two hundred complications, which reflects about 200 patients, were observed in this period. Most complications can be classified as minor. The most frequently observed are obstruction of the tube and granuloma formation. However, major complications, such as peritonitis and aspiration pneumonia, were reported frequently. In addition, in the last five years 13 physicians had observed deaths that were most likely related to gastrostomy. Due to the design of the study, the low response to the questionnaire and the lack of information on the total number of intellectually disabled persons with a gastrostomy, it was not possible to calculate the percentage of persons who experienced a complication. A prospective follow-up study is necessary to examine how the different complications are caused. It would also be advisable to develop a national, harmonised protocol to try to slow down the rate of complications.