Six medical centers from Poland participated in this study: two Departments from Warsaw and one from Poznań,
Łódź, Gdańsk and Katowice. Online electronic medical questionnaire was created to collect important information. The questionnaire was divided into nine sections: personal data (solely data concerning: patient number, patient initials, sex, date of birth), indications for gastrostomy placement, type of tube and tube problems, early and late complications, gastro-esophageal reflux, quality of life, feeding mode after gastrostomy placement, nutritional and biochemical status before gastrostomy placement, nutritional and biochemical status after 6 and 12 months after PEG placement. There was a series of questions in each section. Available medical records of children in whom the first gastrostomy was placed between 2000 and 2010 were analyzed in terms of: source and indications selleck chemicals for gastrostomy admission (main diagnosis and coexisting disorders), nutritional status (weight, percentile, learn more biochemical status) and feeding mode preceding gastrostomy placement (orally or via nasogastric tube, type of diet, volume and number of food portions, duration of feeding via nasogastric tube (in weeks) and information if feeding via nasogastric
tube was continued at home. The group of 349 children was investigated (57% males, 43% females). The mean age at first gastrostomy placement was 6.2 ± 7.4 years. Before gastrostomy placement 163 (46.7%) patients were fed orally and 186 (53.7%) patients received enteral nutrition via nasogastric tube. The mean duration of nasogastric tube feeding preceding gastrostomy insertion was 37.6 ± 54.6 weeks. Only 66 (18.9%) not patients received industrial enteral formulas.
Body weight of most patients (278 pts/78%) before gastrostomy placement was under the third percentile for age. Neurological impairment was present in 293 (84%) of cases. The most common indications for gastrostomy administration included dysphagia (259 pts/74%) patients) and malnutrition (62/18%). Other indications were: necessity to increase energy intake (14/4% of cases), terminal care in hospice patients (11/3%) and PEG as a transfer from parenteral to enteral nutrition in 3 cases ( Tab. I). Additionally we analyzed the main diagnosis and coexisting disorders of children qualified for the PEG insertion ( Tab. II). Neurological disorders, especially cerebral palsy were the most common conditions (243 pts/70%). According to the medical records in 258/74% children PEG was performed, 80/23% patients underwent surgical procedure, and there was lack of data in 11 cases. Based on our experience the former indication for gastrostomy insertion was difficulty in swallowing due to neurological disorders (243 pts/70%). The majority of those patients suffered from cerebral palsy (94 out of 243).