PP038
WHO BENEFITS FROM GASTROSTOMY? FACTORS ASSOCIATED WITH POST-PROCEDURAL MORTALITY IN OLDER PATIENTS
M. ASLAN YETER1, E. GECEGELEN1, Y. N. DOGANCI2, F. TAMER2, N. ERTEN2, S. ATAC3, P. ONAR3, B. KELLECI CAKIR4, C. SIMSEK5, C. BALCI1, M. ESME1,*, S. K. DEMIRKAN4, M. G. HALIL1
1Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 2Nutrition Nurse, 3Clinical Dietitian, Hacettepe University Hospitals, 4Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University Faculty of Pharmacy, 5Division of Gastroenterology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara , Türkiye
Rationale: Gastrostomy provides long-term enteral nutrition for older patients with neurological disorders, malignancy, or prolonged critical illness. Despite its benefits, post-procedural mortality remains high. This study identifies predictors of 60-day and 180-day mortality to refine patient selection and clinical decision-making.
Methods: In this cohort study, patients aged ≥60 years who underwent their first gastrostomy were analyzed. Kaplan–Meier survival analysis was used to estimate survival after gastrostomy and to assess the pattern of early mortality. Based on the survival distribution, 60-day mortality was selected as the primary early outcome. Multivariable logistic regression was used to identify independent predictors of 60-day mortality, while Cox proportional hazards regression was performed to determine factors associated with 180-day mortality risk.
Results: The study included 253 patients with a median survival of 31 days (95% confidence interval [CI]: 21.9–40.1).
60-Day Mortality Predictors: Male sex (odds ratio [OR]=2.05, p=0.02), presence of pressure ulcers (OR=2.27, p=0.009), C-reactive protein (CRP) level (OR=1.008, p=0.001), and chronic kidney disease (CKD) (OR=2.22, p=0.049) as independent predictors of early mortality.
180-Day Survival Predictors: Higher body mass index (BMI) (hazard ratio [HR]=0.958, p=0.032), neurological disease as the indication for gastrostomy (HR=0.697, p=0.038), and gastrostomy performed due to prolonged intensive care unit (ICU) stay or tracheostomy (HR=0.600, p=0.008) were independently associated with lower 180-Day mortality
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Conclusion: High early mortality after gastrostomy in older patients necessitates precise patient selection based on independent predictors like comorbidities and inflammatory markers. Identifying these risk factors is crucial to optimize clinical outcomes and guide procedural decision-making in this vulnerable population.
Disclosure of Interest: None declared