Mortality and Futility in Patients Undergoing Gastrostomy Between 2020 and 2023
DOI:
https://doi.org/10.22516/25007440.1295Keywords:
Gastrostomy, treatment futility, SARS-CoV-2, mortality, bioethicsAbstract
Gastrostomy is a common procedure in hospitals and clinics, typically associated with a low complication rate, and is performed in patients requiring long-term artificial feeding. In daily clinical practice, uncertainty often arises regarding the potential futility of some of these procedures, particularly given the poor vital and functional prognosis of many patients who require them. This study collected data on patients who underwent gastrostomy between 2020 and 2023 at a tertiary care institution, aiming to quantify in-hospital mortality and determine the proportion of procedures deemed futile. Futility in this context was defined as the performance of gastrostomy in patients with advanced dementia, a persistent vegetative state, or death within the first week following the procedure. Overall, in-hospital mortality was found to be 13.1%, and 10.4% of gastrostomies were considered futile. Additionally, higher rates of procedure-related complications and in-hospital deaths were observed during the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A downward trend in futile procedures was noted following the implementation of an institutional protocol on the subject during the study period.
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