Context.— Although the use of feeding tubes among older individuals stirs considerable
controversy, population-based descriptive data regarding patient outcomes
Objective.— To describe hospitalized Medicare beneficiaries having gastrostomies
placed and their associated mortality rates.
Design.— Retrospective cohort study.
Setting and Patients.— Hospitalized Medicare beneficiaries aged 65 years or older discharged
in 1991 following gastrostomy placement (excluding individuals in health maintenance
Main Outcome Measures.— Mortality at 30 days, 1 year, and 3 years following gastrostomy and
characteristics of individuals undergoing gastrostomy placement.
Results.— In 1991, claims reflecting gastrostomy insertion were submitted for
81105 older Medicare beneficiaries following hospital discharge. The in-hospital
mortality rate was 15.3%. Cerebrovascular disease, neoplasms, fluid and electrolyte
disorders, and aspiration pneumonia were the most common primary diagnoses.
The overall mortality rate at 30 days was 23.9% (95% confidence interval [CI],
23.65%-24.2%), reaching 63.0% (95% CI, 62.7%-63.4%) at 1 year and 81.3% (95%
CI, 81.0%-81.5%) by 3 years. One in 131 white and 1 in 58 black Medicare beneficiaries
aged 85 years or older was discharged alive or deceased from a hospital in
1991 following gastrostomy placement.
Conclusions.— Gastrostomies are frequently placed in older individuals and more often
in blacks; mortality rates following placement are substantial.