Indications for gastrostomy feeding in Polish children-Multicenter retrospective analysis of ten years period (2000-2010)

Introduction: The aim of the study was to analyze retrospectively the indications for gastrostomy in Polish children. Six medical centers which have been providing enteral nutrition participated in this study. Methods: Available medical records of children in whom the first gastrostomy was placed between 2000 and 2010 were analyzed in terms of: source and indications for gastrostomy admission, nutritional status and feeding mode preceding gastrostomy placement. Results: The analyzed group comprised of 349 children (57% males, 43% females). The mean age at first gastrostomy placement was 6.2 ± 7.4 years. 163 (46.7%) patients were fed orally and 186 (53.7%) patients received enteral nutrition via nasogastric tube before gastrostomy placement. The mean duration of nasogastric tube feeding before gastrostomy insertion amounted 37.6 ± 54.6 weeks. Body weight of most patients (278/78%) before gastrostomy placement was under the third percentile for age. Neurological impairment was present in 293 (84%) of cases. The most common indications for gastrostomy administration included dysphagia (259/74%) patients) and malnutrition (62/18%). Other indications were: necessity to increase energy intake (14/4% of cases), terminal care in hospice patients (11/3%) and gastrostomy as a transfer from parenteral to enteral nutrition in 3 cases. Based on medical records percutaneous endoscopic gastrostomy (PEG) was performed in 258/74% children, 80/23% patients underwent surgical procedure, and there was lack of data in 11 cases. Conclusion: The main indication for pediatric gastrostomy in Polish sites was neurological disorders with dysphagia. Malnutrition was reported in most of children before gastrostomy placement.