Tubefeeding and Mortality in Children With Severe Disabilities and Mental Retardation

作者：David Strauss, Theodore A. Kastner, Stephen Ashwal, James Francis White · 发表于：PEDIATRICS · 年份：1997 · DOI：10.1542/peds.99.3.358 · 被引用次数：80 · 研究领域：Child Nutrition and Feeding Issues、Dysphagia Assessment and Management、Child Nutrition and Water Access

OBJECTIVE: To study the contribution of tubefeeding to mortality for children with severe disabilities and mental retardation. Previous research has suggested an association between tubefeeding and mortality. However, risk has never been determined using population-based data or defined in regard to patient variables. METHODS: Retrospective analysis of a comprehensive statewide data set comprised of 4921 children with severe disabilities and mental retardation living in community and congregate care settings. The outcome measure was mortality; primary study variables included the presence of a feeding tube, measures of functional independence, type of residence, and medical comorbidity. RESULTS: There were four findings. First, the use of a feeding tube was associated with virtually every disability. Second, when no study variables were controlled, statistically significant differences in mortality rates were noted between children who were tubefed and those who were not. The relative risk of mortality associated with use of a feeding tube was 2.1. Third, the use of a feeding tube was associated with a reduction in relative risk of mortality in children with tracheostomy (relative risk of mortality: .55). However, this association did not achieve statistical significance. Fourth, when study variables were controlled in a multivariate analysis, feeding tube use was associated with no identifiable increase in mortality among children with very severe disabilities, but was assoc...