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P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease

INTRODUCTION: An FVC<50% has traditionally been used to quantify the risk of respiratory compromise in patients with motor neurone disease(MND) undergoing gastrostomy insertion. More recently, a Risk Stratifying Tool(RST) has been developed to better identify those patients who might be at higher...

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Autores principales: Parker, J, Banks, J, Lau, H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10591776/
http://dx.doi.org/10.1093/sleepadvances/zpad035.183
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author Parker, J
Banks, J
Lau, H
author_facet Parker, J
Banks, J
Lau, H
author_sort Parker, J
collection PubMed
description INTRODUCTION: An FVC<50% has traditionally been used to quantify the risk of respiratory compromise in patients with motor neurone disease(MND) undergoing gastrostomy insertion. More recently, a Risk Stratifying Tool(RST) has been developed to better identify those patients who might be at higher risk for the procedure. We set out to evaluate whether there were any differences in the outcomes of high-risk MND patients undergoing gastrostomy insertion as determined by the FVC or RST. METHODS: A retrospective review of MND patients undergoing gastrostomy insertion was performed between June 2018 and June 2023. Data was collected on demographics, RST variables (orthopnoea, elevated serum bicarbonate or pCO2, or use of NIV), complications, and mortality. RESULTS: 42 patients were referred for gastrostomy insertion, only 1 procedure was unsuccessful due to anatomical difficulties. 17 patients (n=8 PEG,n=9 RIG) were classified as high-risk based on FVC<50%, while 30 patients (n=17 PEG,n=13 RIG) were classified as high-risk using the RST. No direct procedure-related complications were recorded in either group. Length of stay(3 vs 3.04 days), 30-day morbidity(23.5% vs 30%), 30-day mortality(0% vs 0%), 6-month mortality(23.5% vs 20%), and median survival(271 days vs 309 day) were comparable between the FVC and RST groups respectively. The RST was more sensitive at identifying patient mortality at 6 months (4/6 vs 6/6 patients). CONCLUSION: Gastrostomy insertion was safe in this cohort of high-risk MND patients, independent of the tool used. Similar morbidity, mortality and length of stay were observed between the two groups. RST was more sensitive for identifying 6-month mortality.
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spelling pubmed-105917762023-10-24 P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease Parker, J Banks, J Lau, H Sleep Adv Poster Viewing Presentations INTRODUCTION: An FVC<50% has traditionally been used to quantify the risk of respiratory compromise in patients with motor neurone disease(MND) undergoing gastrostomy insertion. More recently, a Risk Stratifying Tool(RST) has been developed to better identify those patients who might be at higher risk for the procedure. We set out to evaluate whether there were any differences in the outcomes of high-risk MND patients undergoing gastrostomy insertion as determined by the FVC or RST. METHODS: A retrospective review of MND patients undergoing gastrostomy insertion was performed between June 2018 and June 2023. Data was collected on demographics, RST variables (orthopnoea, elevated serum bicarbonate or pCO2, or use of NIV), complications, and mortality. RESULTS: 42 patients were referred for gastrostomy insertion, only 1 procedure was unsuccessful due to anatomical difficulties. 17 patients (n=8 PEG,n=9 RIG) were classified as high-risk based on FVC<50%, while 30 patients (n=17 PEG,n=13 RIG) were classified as high-risk using the RST. No direct procedure-related complications were recorded in either group. Length of stay(3 vs 3.04 days), 30-day morbidity(23.5% vs 30%), 30-day mortality(0% vs 0%), 6-month mortality(23.5% vs 20%), and median survival(271 days vs 309 day) were comparable between the FVC and RST groups respectively. The RST was more sensitive at identifying patient mortality at 6 months (4/6 vs 6/6 patients). CONCLUSION: Gastrostomy insertion was safe in this cohort of high-risk MND patients, independent of the tool used. Similar morbidity, mortality and length of stay were observed between the two groups. RST was more sensitive for identifying 6-month mortality. Oxford University Press 2023-10-23 /pmc/articles/PMC10591776/ http://dx.doi.org/10.1093/sleepadvances/zpad035.183 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Sleep Research Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Viewing Presentations
Parker, J
Banks, J
Lau, H
P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease
title P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease
title_full P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease
title_fullStr P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease
title_full_unstemmed P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease
title_short P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease
title_sort p098 risk stratification tool for gastrostomy insertion in motor neurone disease
topic Poster Viewing Presentations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10591776/
http://dx.doi.org/10.1093/sleepadvances/zpad035.183
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