Scientific PapersPercutaneous endoscopic gastrostomy reduces total hospital costs in head-injured patients
Section snippets
Methods
Between July 1, 1990, and July 1, 1996, 132 patients were identified from our computerized trauma registry as having suffered head injuries and required a gastrostomy. The hospital chart was then reviewed for demographic data, associated injuries, length of total hospital stay and ICU stay, type and location of gastrostomy, and discharge disposition. The number of separate operative procedures required to treat traumatic injuries or their complications was also recorded. Procedures performed
Results
Between July 1, 1990, and July 1, 1996, 132 patients with TBI underwent placement of a gastrostomy tube. Eighty-eight patients underwent OPEN gastrostomy and 44 patients underwent PEG. Twelve PEG tubes were placed in the OR, 13 were placed in the endoscopy suite, and 19 were placed in the ICU. Table Ilists the demographic data for patients who had OPEN gastrostomies and PEGs. There were no differences between groups with respect to age, initial Glasgow coma score, injury severity score, number
Comments
Patients with severe TBI frequently have a persistent deficit in neurological arousal and neurologic function and often require a prolonged period of convalescence and rehabilitation. Many of these patients are unable to meet their own nutritional needs, and therefore supplemental nutrition is required.5 Although some authors have demonstrated a decrease in lower esophageal sphincter tone in patients with TBI and have recommended that gastric feeding be avoided,6 many authors have demonstrated
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