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Radiologically inserted gastrostomy tube in neurological disease: A retrospective study
OBJECTIVES: This study aimed to compare the safety and efficacy of balloon and non-balloon (or dilator) gastrostomy devices in radiologically inserted gastrostomy (RIG) for patients with neurological disease. MATERIAL AND METHODS: A retrospective analysis of 152 patients was conducted at a tertiary...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Scientific Scholar
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629245/ https://www.ncbi.nlm.nih.gov/pubmed/37941924 http://dx.doi.org/10.25259/JCIS_78_2023 |
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author | Zaita, Brittany Marie Ghosh, Abheek Lee, Sean Raymond, Aislynn Agnihotri, Tanvir Akhter, Nabeel M. |
author_facet | Zaita, Brittany Marie Ghosh, Abheek Lee, Sean Raymond, Aislynn Agnihotri, Tanvir Akhter, Nabeel M. |
author_sort | Zaita, Brittany Marie |
collection | PubMed |
description | OBJECTIVES: This study aimed to compare the safety and efficacy of balloon and non-balloon (or dilator) gastrostomy devices in radiologically inserted gastrostomy (RIG) for patients with neurological disease. MATERIAL AND METHODS: A retrospective analysis of 152 patients was conducted at a tertiary care hospital from July 2017 to September 2020. 104 and 48 patients were included in the balloon and non-balloon groups, respectively. The frequency of complications per specific neurological indication as well as the breakdown of the different complications pertaining to each indication was recorded for analysis. The recovery time, fluoroscopy time, contrast volume, peak radiation, and pain management dosages for each procedure were all reviewed to evaluate for statistical differences between the balloon and non-balloon groups. An adjusted model odds ratio (OR) was conducted to evaluate how each of the variables (type of gastrostomy tube, body mass index [BMI], age, and gender) affected the frequency of complications within our cohort. RESULTS: This study included 152 patients, with an average age of 65.17 years (interquartile range [IQR] = 12.66) and an average BMI of 26.97 (IQR = 7.19). The majority of patients were male (71.1%). The most common indication for the procedure was stroke (24.3%), followed by post-intubation dysphagia (16.4%) and intracranial hemorrhage (11.8%). Amyotrophic lateral sclerosis (ALS) and altered mental status had a similar prevalence at 9.9%. The overall complication rate was 33.8%, overall mortality rate 3.3%, 30-day mortality rate of 2.6%, and no other major complications according to CIRSE criteria. Notably, patients with neurodegenerative disorders exhibited comparable rates of minor complications: 33.3% in ALS (5/15 patients), 50% in myasthenia gravis (1/2 patients), and 100% in muscular dystrophy (1/1 patient). The study compared two groups: the balloon group (104 patients) and the dilator group (48 patients). The balloon group received significantly lower preoperative sedation in the form of fentanyl (Avg = 4.46 min vs. 6.54 min, P = 0.287). The balloon group had shorter fluoroscopy time, lower radiation exposure dose, and shorter operating time compared to the dilator group, though not statistically significant. In the logistic regression model, there was no statistical difference in complication rates between the dilator and balloon groups. BMI, age, and gender did not significantly affect minor complication rates. CONCLUSION: RIG tube insertions may serve as a valuable, alternative approach in providing enteral support in patients with neurological disease. |
format | Online Article Text |
id | pubmed-10629245 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-106292452023-11-08 Radiologically inserted gastrostomy tube in neurological disease: A retrospective study Zaita, Brittany Marie Ghosh, Abheek Lee, Sean Raymond, Aislynn Agnihotri, Tanvir Akhter, Nabeel M. J Clin Imaging Sci Original Research OBJECTIVES: This study aimed to compare the safety and efficacy of balloon and non-balloon (or dilator) gastrostomy devices in radiologically inserted gastrostomy (RIG) for patients with neurological disease. MATERIAL AND METHODS: A retrospective analysis of 152 patients was conducted at a tertiary care hospital from July 2017 to September 2020. 104 and 48 patients were included in the balloon and non-balloon groups, respectively. The frequency of complications per specific neurological indication as well as the breakdown of the different complications pertaining to each indication was recorded for analysis. The recovery time, fluoroscopy time, contrast volume, peak radiation, and pain management dosages for each procedure were all reviewed to evaluate for statistical differences between the balloon and non-balloon groups. An adjusted model odds ratio (OR) was conducted to evaluate how each of the variables (type of gastrostomy tube, body mass index [BMI], age, and gender) affected the frequency of complications within our cohort. RESULTS: This study included 152 patients, with an average age of 65.17 years (interquartile range [IQR] = 12.66) and an average BMI of 26.97 (IQR = 7.19). The majority of patients were male (71.1%). The most common indication for the procedure was stroke (24.3%), followed by post-intubation dysphagia (16.4%) and intracranial hemorrhage (11.8%). Amyotrophic lateral sclerosis (ALS) and altered mental status had a similar prevalence at 9.9%. The overall complication rate was 33.8%, overall mortality rate 3.3%, 30-day mortality rate of 2.6%, and no other major complications according to CIRSE criteria. Notably, patients with neurodegenerative disorders exhibited comparable rates of minor complications: 33.3% in ALS (5/15 patients), 50% in myasthenia gravis (1/2 patients), and 100% in muscular dystrophy (1/1 patient). The study compared two groups: the balloon group (104 patients) and the dilator group (48 patients). The balloon group received significantly lower preoperative sedation in the form of fentanyl (Avg = 4.46 min vs. 6.54 min, P = 0.287). The balloon group had shorter fluoroscopy time, lower radiation exposure dose, and shorter operating time compared to the dilator group, though not statistically significant. In the logistic regression model, there was no statistical difference in complication rates between the dilator and balloon groups. BMI, age, and gender did not significantly affect minor complication rates. CONCLUSION: RIG tube insertions may serve as a valuable, alternative approach in providing enteral support in patients with neurological disease. Scientific Scholar 2023-10-30 /pmc/articles/PMC10629245/ /pubmed/37941924 http://dx.doi.org/10.25259/JCIS_78_2023 Text en © 2023 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Research Zaita, Brittany Marie Ghosh, Abheek Lee, Sean Raymond, Aislynn Agnihotri, Tanvir Akhter, Nabeel M. Radiologically inserted gastrostomy tube in neurological disease: A retrospective study |
title | Radiologically inserted gastrostomy tube in neurological disease: A retrospective study |
title_full | Radiologically inserted gastrostomy tube in neurological disease: A retrospective study |
title_fullStr | Radiologically inserted gastrostomy tube in neurological disease: A retrospective study |
title_full_unstemmed | Radiologically inserted gastrostomy tube in neurological disease: A retrospective study |
title_short | Radiologically inserted gastrostomy tube in neurological disease: A retrospective study |
title_sort | radiologically inserted gastrostomy tube in neurological disease: a retrospective study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629245/ https://www.ncbi.nlm.nih.gov/pubmed/37941924 http://dx.doi.org/10.25259/JCIS_78_2023 |
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