A retrospective survey of tube-related complications in patients receiving long-term home enteral nutrition.

Percutaneous gastrostomy tubes are associated with low insertional morbidity. The purpose of this study was to determine the long-term complications of enteral feeding tubes and the effect of these complications on patients, their caregivers and health care utilization. In the province of Manitoba, a regional program supervises all individuals on home enteral nutrition. A retrospective survey was administered to individuals agreeing to participate in the study. This retrospective survey included 30 questions relating to the frequency and severity of tube-related problems, utilization of health care resources due to tube-related problems, and effects of tube feeding on the quality of life of patients and their caregivers. The survey was completed by 55/211 patients in the home enteral nutrition program. Adult and pediatric patients were included and the mean duration of time on home enteral nutrition was 25.9 months. Common complications (percentage of patients experiencing complication) included granulation tissue formation (67%), broken or leaking tube (56%) leakage around the tube site (60%) and stomal infection requiring antibiotics (45%). Health care utilization (% of individuals) related to gastrostomy tubes included phone contact (69%), clinic visit (45%) ER visit (35%), and hospital admission (11%). This survey reveals that tube-related complications are common in patients receiving long-term home enteral nutrition. While these complications are not life threatening, they are associated with increased health care utilization. Prospective studies are needed to confirm these findings and assess the effect of these complications on health care utilization and quality of life of the patient and the primary caregiver.