PEG Tubes Linked to Increased Risk of New Pressure Ulcers

And existing pressure ulcers less likely to heal for nursing home residents with cognitive impairment

THURSDAY, May 17 (HealthDay News) -- Percutaneous endoscopic gastrostomy (PEG) feeding tubes significantly increase the risk of new pressure ulcers and do not promote the healing of existing pressure ulcers in nursing home residents with advanced cognitive impairment, according to a study published in the May 14 issue of the Archives of Internal Medicine.

To investigate whether PEG tubes prevent or help heal pressure ulcers, Joan M. Teno, M.D., of the Warren Alpert Medical School of Brown University in Providence, R.I., and colleagues conducted a propensity-matched cohort study involving nursing home residents with advanced cognitive impairment. The Minimum Data Set was examined to see whether 1,124 residents without a pressure ulcer, with PEG insertion, developed a stage 2 or higher ulcer; and to investigate the improvement of pressure ulcers in 461 residents with a pressure ulcer. Each resident with a feeding tube was matched to three without a PEG tube.

The researchers found that hospitalized nursing home residents with a PEG feeding tube were 2.27 times more likely to develop a new stage 2 or higher pressure ulcer, after adjustment for risk factors. The likelihood of having an existing pressure ulcer heal was significantly lower for those with a PEG tube inserted (odds ratio, 0.70).

"Feeding tubes are not associated with prevention or improved healing of a pressure ulcer," the authors write. "Rather, our findings suggest that the use of PEG tube is associated with increased risk of pressure ulcers among nursing home residents with advanced cognitive impairment."

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