Dataset Information

Esophageal feeding tube placement and the associated complications in 248 cats.

ABSTRACT: BACKGROUND:Esophageal feeding tubes are commonly used to provide enteral nutrition to cats, but their use is associated with adverse effects. OBJECTIVES:To evaluate the complications associated with e-tube placement in cats and to identify factors predisposing to these complications. ANIMALS:Cats that had an esophageal feeding tube placed (n?=?248). METHODS:This was a retrospective case review in which clinical records were interrogated across 2 referral centers to identify records of cats that had esophageal tubes placed. Clinical data were collected for signalment, clinical indication, method of placement, time of removal, and any complications. Logistic regression was then employed to assess the odds of an increase in complications, including infection and death. RESULTS:For those cats that survived to discharge, tubes were in place for a median of 11?days, ranging from 1 to 93?days. Complications occurred in 35.8% of the cats, with the most common being tube dislodgement (14.5%), followed by stoma site infections (12.1%). Cats receiving glucocorticoids or oncolytic agents (OR?=?3.91; 95% CI, 1.14-13.44) and with discharge at the stoma site (OR?=?159.8; CI, 18.9-1351) were at an increased odds of developing a stoma site infection, whereas those with a lower weight (OR?=?1.33; 95% CI, 1.02-1.75) or (pancreatic [OR?=?4.33; 95% CI, 1.02-18.47], neoplastic [OR?=?15.44; 95% CI, 3.67-65.07], respiratory [OR?=?19.66; 95% CI, 2.81-137.48], urogenital [OR?= 5.78; 95% CI, 1.15-28.99], and infectious diseases [OR?=?11.57; 95% CI, 2.27-58.94]) had an increased odds of death. The duration of time in place and the cat being discharged with the tube in place were not associated with an increased risk of infection or death. CONCLUSIONS AND CLINICAL IMPORTANCE:Owners should be made aware of the potential risks involved and their predisposing factors.

SUBMITTER: Breheny CR

PROVIDER: S-EPMC6524112 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Esophageal feeding tube placement and the associated complications in 248 cats.

Breheny Craig R CR Boag Alisdair A Le Gal Alice A Hõim Sven-Erik SE Cantatore Matteo M Anderson Davina D Nuttall Tim T Chandler Marjoie L ML Gunn-Moore Danièlle A DA

Journal of veterinary internal medicine 20190418 3

<h4>Background</h4>Esophageal feeding tubes are commonly used to provide enteral nutrition to cats, but their use is associated with adverse effects.<h4>Objectives</h4>To evaluate the complications associated with e-tube placement in cats and to identify factors predisposing to these complications.<h4>Animals</h4>Cats that had an esophageal feeding tube placed (n = 248).<h4>Methods</h4>This was a retrospective case review in which clinical records were interrogated across 2 referral centers to i ...[more]

PMID: 31001901

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Project description:Importance:A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. Objective:To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC. Design, Setting, and Participants:Cohort study at a tertiary care and referral center for patients with HNSCC serving the northern Chicago region. Patients were treated for squamous cell carcinomas of the hypopharynx, oropharynx, and nasopharynx from 2004 to 2015 with radiation or chemoradiation therapy in the definitive or adjuvant setting. Patients who received less than 5000 cGy radiation or underwent reirradiation were excluded. Interventions:A proactive SLP program for patients with HNSCC was initiated in 2011. Study cohorts were divided into 2 groups: 2004 through 2010 and 2011 through 2015. Main Outcomes and Measures:Primary outcome variables were SLP referral placement and timing of the referral. Secondary outcomes were feeding tube placement and ability to tolerate any oral intake. Results:A total of 254 patients met inclusion criteria (135 before and 119 after implementation of SLP program; median age, 60 years [range, 14-94 years]; 77% male). With the initiation of a proactive SLP program, pretreatment evaluations increased from 29 (21.5%) to 70 (58.8%; risk ratio [RR], 2.74; 95% CI, 1.92-3.91), and rate of referral overall at any time increased from 60.0% to 79.8% (RR, 1.33; 95% CI, 1.13-1.57). Feeding tube placement rates decreased from 45.9% (n = 62) to 29.4% (n = 35; RR, 0.64; 95% CI, 0.46-0.89). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation (31 of 99 [31%]) than for those referred during (11 of 18 [61%]) or after (38 of 59 [64%]) treatment. The rate of tolerating any oral intake at the end of treatment improved from 71.1% (n = 96) in the preimplementation period to 82.4% (n = 98; RR, 1.16; 95% CI, 1.01-1.33). Conclusions and Relevance:A proactive SLP program can be successfully established as part of the multidisciplinary care of patients with HNSCC and improve patient quality of life.

Project description:BackgroundPalliative treatments and stents are necessary for relieving dysphagia in patients with esophageal cancer. The aim of this study was to simultaneously compare available treatments in terms of complications.MethodsWeb of Science, Medline, Scopus, Cochrane Library and Embase were searched. Statistical heterogeneity was assessed using the Chi2 test and was quantified by I2. The results of this study were summarized in terms of Risk Ratio (RR). The random effects model was used to report the results. The rank probability for each treatment was calculated using the p-score.ResultsOut of 17855 references, 24 RCTs reported complications including treatment related death (TRD), bleeding, stent migration, aspiration, severe pain and fistula formation. In the ranking of treatments, thermal ablative therapy (p-score = 0.82), covered Evolution® stent (p-score = 0.70), brachytherapy (p-score = 0.72) and antireflux stent (p-score = 0.74) were better treatments in the network of TRD. Thermal ablative therapy (p-score = 0.86), the conventional stent (p-score = 0.62), covered Evolution® stent (p-score = 0.96) and brachytherapy (p-score = 0.82) were better treatments in the network of bleeding complications. Covered Evolution® (p-score = 0.78), uncovered (p-score = 0.88) and irradiation stents (p-score = 0.65) were better treatments in network of stent migration complications. In the network of severe pain, Conventional self-expandable nitinol alloy covered stent (p-score = 0.73), polyflex (p-score = 0.79), latex prosthesis (p-score = 0.96) and brachytherapy (p-score = 0.65) were better treatments.ConclusionAccording to our results, thermal ablative therapy, covered Evolution® stents, brachytherapy, and antireflux stents are associated with a lower risk of TRD. Moreover, thermal ablative therapy, conventional, covered Evolution® and brachytherapy had lower risks of bleeding. Overall, fewer complications were associated with covered Evolution® stent and brachytherapy.

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Esophageal feeding tube placement and the associated complications in 248 cats.

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Esophageal feeding tube placement and the associated complications in 248 cats.

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