Mitchell et al identified risk factors for placement of a feeding tube in a nursing home resident with severe cognitive impairment. The authors are from Beth Deaconess Medical Center and Harvard Medical School in Boston.
Patient selection: nursing home resident > 65 years of age with severe cognitive impairment
Risk factors associated with feeding tube placement:
(1) age < 87 years
(2) history of aspiration
(3) difficulty swallowing
(4) history of stroke
(5) presence of a pressure ulcer
Aspiration had the highest odds ratio for placement (5.5).
Factors making feeding tube placement less likely:
(1) moderate or severe functional impairment
(2) Do-not-resuscitate order
(3) dementia
Placement of a feeding tube was not associated with improved survival.
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