The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia

被引：15

作者：

Suzuki, Yutaka ^{[1
]}

Urashima, Mitsuyoshi ^{[2
]}

Izumi, Masaki ^{[3
]}

Ito, Yasuhiko ^{[4
]}

Uchida, Nobuyuki ^{[5
]}

Okada, Shingo ^{[6
]}

Ono, Hiromi ^{[7
]}

Orimo, Satoshi ^{[8
]}

Kohri, Takayuki ^{[9
]}

Shigoka, Hiroaki ^{[10
]}

Shintani, Shuzo ^{[11
]}

Tanaka, Yukiko ^{[12
]}

Yoshida, Atsushi ^{[13
]}

Ijima, Masashi ^{[14
]}

Ito, Toru ^{[15
]}

Endo, Takao ^{[16
]}

Okano, Hitoshi ^{[17
]}

Maruyama, Michio ^{[18
]}

Iwase, Tsuyoshi ^{[19
]}

Kikuchi, Tsutomu ^{[20
]}

Kudo, Michiaki ^{[21
]}

Takahashi, Mikako ^{[22
]}

Goshi, Satoshi ^{[23
]}

Mikami, Tatsuya ^{[24
]}

Yamashita, Satoyoshi ^{[25
]}

Akiyama, Kazuhiro ^{[26
]}

Ogawa, Tetsushi ^{[27
]}

Ogawa, Tomoko ^{[28
]}

Ono, Shigeki ^{[29
]}

Onozawa, Shigeru ^{[30
]}

Kobayashi, Junya ^{[31
]}

Matsumoto, Masami ^{[32
]}

Matsumoto, Toshifumi ^{[33
]}

Jomoto, Kazuaki ^{[34
]}

Mizuhara, Akihiro ^{[35
]}

Nishiguchi, Yukio ^{[36
]}

Nishiwaki, Shinji ^{[37
]}

Aoki, Masahiko ^{[38
]}

Ishizuka, Izumi ^{[39
]}

Kura, Toshiroh ^{[40
]}

Murakami, Masato ^{[41
]}

Murakami, Akihiko ^{[42
]}

Ohta, Tomoyuki ^{[43
]}

Onishi, Koji ^{[44
]}

Nakahori, Masato ^{[45
]}

Tsuji, Tsuyotoshi ^{[46
]}

Tahara, Ko ^{[47
]}

Tanaka, Ikuta ^{[48
]}

Kitagawa, Kazuhiko ^{[49
]}

Shimazaki, Makoto ^{[50
]}

机构：

[1] Int Univ Hlth & Welf Hosp, Dept Surg, Nasushiobara, Tochigi 3292763, Japan

[2] Jikei Univ, Sch Med, Dept Mol Epidemiol, Minato Ku, 3-25-8 Nishi Shimbashi, Tokyo, Japan

[3] Tokyo Musashino Hosp, Dept Internal Med, Itabashi Ku, Tokyo, Japan

[4] Suzuki Internal Med Clin, Nagareyama, Chiba 2700157, Japan

[5] Haramachi Red Cross Hosp, Dept Surg, Gunma 3770882, Japan

[6] Kitamihara Clin, Dept Surg, Hakodate, Hokkaido 0410802, Japan

[7] Seiwa Mem Hosp, Dept Internal Med, Nishi Ku, Sapporo, Hokkaido 0630811, Japan

[8] Kanto Cent Hosp, Dept Neurol, Tokyo 1588531, Japan

[9] Tone Chuou Hosp, Dept Surg, Numata, Gunma 378005, Japan

[10] Toho Univ, Ohashi Med Ctr, Dept Internal Med, Div Gastroenterol,Meguro Ku, Tokyo, Japan

[11] JA Toride Med Ctr, Dept Neurol, Toride, Ibaraki 3020022, Japan

[12] Uchida Hosp, Internal Dept, Numata, Gunma 3780005, Japan

[13] Ohfuna Chuo Hosp, Ctr Digest & Liver Dis, Kamakura, Kanagawa 2470056, Japan

[14] Isesaki City Hosp, Dept Internal Med, Isesaki, Gunma 3720812, Japan

[15] Nakamura Mem Hosp, Dept Surg, Sapporo, Hokkaido 0608570, Japan

[16] Sapporo Shirakaba Dai Hosp, Dept Gastroenterol, Sapporo, Hokkaido 0620052, Japan

[17] Okano clin, Dept Gastroenterol, Sakyo Ku, Kyoto, Kyoto 6068411, Japan

[18] Tokyo Metropolitan Ohkubo Hosp, Dept Surg, Sinnjyuku Ku, Tokyo, Japan

[19] Kyoto Kujo Hosp, Dept Internal Med, Minami Ku, Kyoto, Kyoto 6018485, Japan

[20] Kanazawa Nishi Hosp, Dept Surg, Kanazawa, Ishikawa 9200025, Japan

[21] Onishi Hosp, Dept Surg, Fujika, Gunma 3701401, Japan

[22] Tsuruika Kyouritsu Hosp, Dept Internal Med, Tsuruoka, Yamagata 9970816, Japan

[23] Niigata Joetsu Gen Hosp, Japan Agr Cooperat, Dept Gastroenterol & Hepatol, Joetsu, Niigata 9438507, Japan

[24] Hirosaki Municipal Hosp, Dept Gastroenterol, Hirosaki, Aomori 0368004, Japan

[25] Shimonoseki Welf Hosp, Dept Gastroenterol, Shimonoseki, Yamaguchi 7500061, Japan

[26] Tokatsu Clin Hosp, Dept Surg, Matsudo, Chiba 2710067, Japan

[27] Maebashi Red Cross Hosp, Dept Surg, Maebashi, Gunma 3710014, Japan

[28] Int Univ Hlth & Welf Hosp, Dept Neurol, Nasushiobara, Tochigi 3292763, Japan

[29] Ako City Hosp, Dept Gastroenterol, Ako, Hyogo 6780232, Japan

[30] Kameda Med Ctr, Dept HomeCareMed, Kamogawa, Chiba 2928601, Japan

[31] Fujiyoshida Municipal Hosp, Dept Surg, Fujiyoshida, Yamanashi 4030005, Japan

[32] Nara Prefectural Gojo Hosp, Dept Internal Med, Gojo, Nara 6378511, Japan

[33] Natl Hosp Org, Beppu Med Ctr, Dept Surg, Beppu, Oita 8740011, Japan

[34] Jomoto Gastroenter & Internal Med Clin, Kumamoto, Kumamoto 8620976, Japan

[35] Higashi Washinomiya Hosp, Dept Cardiol & Vasc Surg, Kuki, Saitama 3400203, Japan

[36] Osaka City Gen Hosp, Dept Surg Gastroenterol, Miyakojima Ku, Osaka, Osaka 5340021, Japan

[37] Nishimino Kosei Hosp, Dept Internal Med, Gifu 5031394, Japan

[38] Ohtawara Red Cross Hosp, Dept Surg, Ohtawara, Tochigi 3248686, Japan

[39] Kohka Publ Hosp, Dept Internal Med, Kohka, Shiga 5280014, Japan

[40] Naganuma Municipal Hosp, Dept Gastroenterol, Yubari Gun, Hokkaido 0691332, Japan

[41] Murakami Mem Hosp, Dept Internal Med, Saijo, Ehime 7930030, Japan

[42] Iwate Prefectural Cent Hosp, Endoscopy Unit, Morioka, Iwate 0200066, Japan

[43] Sapporo Higashi Tokushukai Hosp, Ctr Gastroenterol, Higashi Ku, Sapporo, Hokkaido 0650033, Japan

[44] Matsue Seikyo Gen Hosp, Internal Med, Matsue, Shimane 6908522, Japan

[45] Sendai Kousei Hosp, Digest Endoscopy Ctr, Sendai, Miyagi 9800873, Japan

[46] Akita City Hosp, Dept Gastroenterol, Akita, Akita 0100933, Japan

[47] Kure Kyosai Hosp, Dept Surg, Kure, Hiroshima 7378505, Japan

[48] Japan Red Cross Date Gen Hosp, Dept Gastroenterol, Date, Hokkaido 0528511, Japan

[49] Tsuchida Hosp, Dept Surg, Sapporo, Hokkaido 0640921, Japan

[50] Hirano Gen Hosp, Dept Gastroenterol, Gifu, Gifu 5011192, Japan

来源：

GASTROENTEROLOGY RESEARCH | 2012年 / 5卷 / 01期

关键词：

Alzheimer's dementia; Cerebrovascular dementia; Percutaneous endoscopic gastrostomy; Quality of life; Risk factor;

D O I：

10.4021/gr392w

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: To examine the effects of percutaneous endoscopic gastrostomy (PEG) on quality of life (QOL) in patients with dementia. Methods: We retrospectively included 53 Japanese community and tertiary hospitals to investigate the relationship between the newly developed PEG and consecutive dementia patients with swallowing difficulty between Jan 1st 2006 and Dec 31st 2008. We set improvements in 1) the level of independent living, 2) pneumonia, 3) peroral intake as outcome measures of QOL and explored the factors associated with these improvements. Results: Till October 31st 2010, 1,353 patients with Alzheimer's dementia (33.1%), vascular dementia (61.7%), dementia with Lewy body disease (2.0%), Pick disease (0.6%) and others were followed-up for a median of 847 days (mean 805 +/- 542 days). A total of 509 deaths were observed (mortality 59%) in full-followed patients. After multivariate adjustments, improvement in the level of independent living was observed in milder dementia, or those who can live independently with someone, compared with advanced dementia, characterized by those who need care by someone: Odds Ratio (OR), 3.90, 95% confidence interval (95% CI), 1.59 -9.39, P = 0.003. Similarly, improvement of peroral intake was noticed in milder dementia: OR, 2.69, 95% CI, 1.17 - 6.17, P = 0.02. Such significant associations were not observed in improvement of pneumonia. Conclusions: These results suggest that improvement of QOL after PEG insertion may be expected more in milder dementia than in advanced dementia.

引用

页码：10 / 20

页数：11

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