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Efficacy of enteral feeding by gastrostomy tube placement in patients with Lennox-Gastaut syndrome on body weight and days of hospitalization: A retrospective case series

Authors
 Sangbo Lee  ;  Ara Ko  ;  Sowon Park  ;  Kyung Won Kim  ;  Kyong Ihn  ;  In Geol Ho  ;  Se Hee Kim  ;  Heung Dong Kim  ;  Joon Soo Lee  ;  Hoon-Chul Kang 
Citation
 NUTRITION IN CLINICAL PRACTICE, Vol.39(5) : 1202-1211, 2024-10 
Journal Title
NUTRITION IN CLINICAL PRACTICE
ISSN
 0884-5336 
Issue Date
2024-10
MeSH
Adolescent ; Adult ; Body Weight ; Child ; Child, Preschool ; Deglutition Disorders / etiology ; Deglutition Disorders / therapy ; Enteral Nutrition* / methods ; Female ; Gastrostomy* / adverse effects ; Gastrostomy* / methods ; Hospitalization / statistics & numerical data ; Humans ; Infant ; Intubation, Gastrointestinal / adverse effects ; Intubation, Gastrointestinal / methods ; Length of Stay / statistics & numerical data ; Lennox Gastaut Syndrome* ; Male ; Malnutrition / etiology ; Malnutrition / therapy ; Nutritional Status ; Retrospective Studies ; Treatment Outcome ; Young Adult
Keywords
Lennox‐Gastaut syndrome ; developmental and epileptic encephalopathy ; gastrostomy tube placement ; hospitalization ; nutrition
Abstract
Background: Lennox-Gastaut syndrome (LGS) is a severe form of drug-resistant epilepsy that begins during childhood and frequently leads to significant neurological impairments. Patients with LGS are likely to receive improper oral nutrition because of issues such as dysphagia and aspiration risk, potentially resulting in long-term tube feeding and eventual gastrostomy tube placement. Therefore, we investigated the effects of gastrostomy tube placement on nutrition outcomes and frequency of hospitalization in LGS.

Methods: We retrospectively examined 67 patients diagnosed with LGS who had undergone gastrostomy tube placement between January 2005 and August 2022. Comprehensive clinical data and complications arising from the procedure were collected. Patients' nutrition condition and frequency of hospitalizations were analyzed before and after gastrostomy tube placement.

Results: Gastrostomy tube placement was performed for the following reasons: high risk of aspiration (50 out of 67, 74.6%), dysphagia (13 out of 67, 25.4%), persistent nasogastric tube feeding (2 out of 67, 3.0%), and severe malnutrition (2 out of 67, 3.0%). After the procedure, z scores for weight-for-age improved significantly, shifting from -3.35 ± 3.57 to -2.54 ± 2.70 over a 2-year interval (P < 0.001). Additionally, the total days of hospitalization and days of hospitalization due to respiratory symptoms reduced significantly from 41.94 ± 51.76 to 15.27 ± 26.68 (P < 0.001) and from 23.75 ± 36.92 to 10.52 ± 22.98 (P = 0.009), respectively. Among the patients, 50 (74.6%) experienced complications resulting from gastrostomy, with a relatively small proportion of major complications (11 out of 67, 16.4%) and no mortality.

Conclusion: Gastrostomy tube placement is a relatively safe procedure with favorable effects on nutrition status and hospitalization rates in patients with LGS.
Full Text
https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/ncp.11177
DOI
10.1002/ncp.11177
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Ko, A Ra(고아라)
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Se Hee(김세희) ORCID logo https://orcid.org/0000-0001-7773-1942
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Park, So Won(박소원) ORCID logo https://orcid.org/0000-0002-2498-8004
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
Ihn, Kyong(인경) ORCID logo https://orcid.org/0000-0002-6161-0078
Ho, In Geol(호인걸)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201334
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