OBJECTIVES: To examine the characteristics and outcomes of children with gastrostomy and gastrojejunostomy tubes inserted before age three years, and to identify the factors that predict removal of the enterostomy tubes within 12 months of insertion. DESIGN: Case review of a consecutive sample of 325 medical records. SETTING: A tertiary care paediatric hospital that is situated in a large metropolitan area. PATIENTS: All outpatients and inpatients from birth to 36 months of age who had an enterostomy tube inserted from 1994 to 1996. METHODS: No direct intervention was provided. In the subgroup of 203 patients with a follow-up period of at least 12 months after tube insertion, children whose tubes were removed within 12 months of insertion were compared with children who continued to receive tube feedings for 12 months or longer. RESULTS: At the time of tube insertion, the median age of patients was six months; 47% of the children for whom data were available were failing to thrive. Although 66 (21%) of 321 patients for whom data were available had their tubes removed, only 25 of the 203 (12%) patients with a follow-up period of 12 months or more had their tubes removed within 12 months of insertion. Children whose tubes were removed less than 12 months after insertion differed from children whose tubes were not removed with respect to medical diagnosis (no children with cerebral palsy had their tubes removed versus 33% of children with cancer who had their tube removed). Most children with failure to thrive at the time of tube insertion were also failing to thrive at the time of tube removal. CONCLUSION: Children with cerebral palsy are not likely to have enterostomy tubes removed within one year of insertion.
OBJECTIVES: To examine the characteristics and outcomes of children with gastrostomy and gastrojejunostomy tubes inserted before age three years, and to identify the factors that predict removal of the enterostomy tubes within 12 months of insertion. DESIGN: Case review of a consecutive sample of 325 medical records. SETTING: A tertiary care paediatric hospital that is situated in a large metropolitan area. PATIENTS: All outpatients and inpatients from birth to 36 months of age who had an enterostomy tube inserted from 1994 to 1996. METHODS: No direct intervention was provided. In the subgroup of 203 patients with a follow-up period of at least 12 months after tube insertion, children whose tubes were removed within 12 months of insertion were compared with children who continued to receive tube feedings for 12 months or longer. RESULTS: At the time of tube insertion, the median age of patients was six months; 47% of the children for whom data were available were failing to thrive. Although 66 (21%) of 321 patients for whom data were available had their tubes removed, only 25 of the 203 (12%) patients with a follow-up period of 12 months or more had their tubes removed within 12 months of insertion. Children whose tubes were removed less than 12 months after insertion differed from children whose tubes were not removed with respect to medical diagnosis (no children with cerebral palsy had their tubes removed versus 33% of children with cancer who had their tube removed). Most children with failure to thrive at the time of tube insertion were also failing to thrive at the time of tube removal. CONCLUSION:Children with cerebral palsy are not likely to have enterostomy tubes removed within one year of insertion.