An American Geriatrics Society/Pfizer Foundation for Health in Aging Postdoctoral Fellowship for Health Outcomes Research in Geriatrics, and a Young Investigator Award from the Huffington Center on Aging supported this work. Drs. Braun and Beyth are recipients of a VA Health Services Research Career Development Award. This work was presented in part at the 2003 Annual Scientific Meeting of the American Geriatrics Society in Baltimore, Maryland.
Decreasing Use of Percutaneous Endoscopic Gastrostomy Tube Feeding for Veterans with Dementia—Racial Differences Remain
Article first published online: 26 JAN 2005
Journal of the American Geriatrics Society
Volume 53, Issue 2, pages 242–248, February 2005
How to Cite
Braun, U. K., Rabeneck, L., McCullough, L. B., Urbauer, D. L., Wray, N. P., Lairson, D. R. and Beyth, R. J. (2005), Decreasing Use of Percutaneous Endoscopic Gastrostomy Tube Feeding for Veterans with Dementia—Racial Differences Remain. Journal of the American Geriatrics Society, 53: 242–248. doi: 10.1111/j.1532-5415.2005.53109.x
- Issue published online: 26 JAN 2005
- Article first published online: 26 JAN 2005
- PEG tube;
- time trends;
- end-of-life care
Objectives: Percutaneous endoscopic gastrostomy (PEG) tube placement is a widely used method for long-term enteral feeding of demented patients unable to take sufficient food by mouth. National time trends in PEG tube use over the last decade have not been previously reported. The objective of this study was to determine whether use of PEG tubes for patients with dementia has changed over time and by race.
Design: Retrospective cohort study.
Setting: All Veterans Affairs hospitals.
Participants: Using an administrative database of the Veterans Health Administration, all veterans with dementia and all veterans who received a PEG tube were identified between fiscal years 1990–2001.
Measurements: Proportion of PEG tube placement for dementia patients over time and by race.
Results: Four hundred thirteen thousand six hundred twenty-seven dementia patients aged 60 and older were identified, of whom 6,464 (1.6%) received a PEG tube. Use of PEG tubes for dementia patients increased during the first half of the decade but subsequently decreased almost to baseline after peaking in 1996 (1990: 1.2%, 1996: 1.8%, 2001: 1.3%). Time trends in the use of PEG tube feeding for dementia patients varied by race. Specifically, the relative risk for PEG tube placement in African-American dementia patients increased from 1.65 (95% confidence interval (CI)=1.25–2.17, FY 1990) to 1.97 (95% CI=1.62–2.4, FY 2001).
Conclusion: Although the overall use of PEG tube feeding for dementia patients decreased over time, rates in use and changes in use over time varied significantly by race. Reasons for the differential use of this procedure should be explored.