More in-hospital adverse events associated with surgical ostomy feeding tubes than with nasal or oral feeding tubes

Reference

Bowman CA, Hutchins E, Burgermaster M, Sant V, Seres DS. Nasal feeding tubes are associated with fewer adverse events than feeding via ostomy in hospitalized patients receiving enteral nutrition. Am J Med 2022;135(1):97-102.

Synopsis

In this prospective cohort study, investigators followed all hospitalized patients with feeding tubes at an academic medical center over a 9-week period. The authors excluded patients with surgical feeding ostomies that were placed during a prior admission. Patients were visited twice weekly, interviewed regarding potential adverse events related to their feeding tubes (a nurse or family member was interviewed if the patient was unable to answer), and examined for any tube-related complications. Further, the presence or absence of chart documentation of any tube-related adverse event was noted. The final cohort consisted of 261 patients (148 with natural orifice feeding tubes [116 with nasogastric tubes and 32 with orogastric tubes] and 113 with surgical ostomies) with 1118 unique observations. The surgical ostomy group included more male patients (63% vs 55%; P <.01) and had fewer observations in the intensive care unit (20% vs 71%; P < .001). Overall, patients in the surgical group had a statistically significant higher incidence of interview-documented adverse events per 100 hospital days (3.34 vs 1.25; P < .001), including more clogs, leaks, and tube-feeding intolerance. Patients with natural orifice feeding tubes had a higher rate of nasal discomfort. No differences were detected in local pain, bleeding, skin irritation, or soft tissue infection. In both groups, only approximately 50% of interview-documented adverse events were recorded in the physician's progress notes.