A Selective Placement Strategy for Surgical Feeding Tubes Benefits Trauma Patients

ABSTRACTBackgroundThe indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long term SFTs. Following this study, we modified our institutional guidelines for SFT placement. We hypothesized that a more selective placement strategy would result in fewer unnecessary SFTs.MethodsA retrospective review of all adult patients from 2012-2016 with an ICU LOS>4 days and a SFT placed during admission was conducted. This group was compared to data collected prior to our change in practice (2007-2010). Data from 2011 was excluded as a washout period. “Necessary” SFT use was defined per established guidelines as either daily use of the SFT through discharge or for ≥28 days and “unnecessary” SFT use as all others.Results257 SFTs were placed from 2007-2010 and 244 from 2012-2016. Following implementation of our selective SFT placement strategy, unnecessary SFT placement decreased from 25% in 2007-2010 to 8% in 2012-2016 (p4 days and a SFT placed during admission was conducted. This group was compared to data collected prior to our change in practice (2007-2010). Data from 2011 was excluded as a washout period. “Necessary” SFT use was defined per established guidelines as either daily use of the SFT through discharge or for ≥28 days and “unnecessary” SFT use as all others. Results 257 SFTs were placed from 2007-2010 and 244 from 2012-2016. Following implementation of our selective SFT placement strategy, unnecessary SFT placement decreased from 25% in 2007-2010 to 8% in 2012-2016 (p

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2FCCOVv