Sažetak | Objectives : The main objectives of this study were to assess nutritional status and quality of life of patients who are enterally feeding via percutaneous endoscopic gastrostomy for a period of at least 3 months in the home environment.
Materials and methods: This study included a total of 31 participants, aged between 21 and 85 years, who have been feeding via percutaneous endoscopic gastrostomy for a period of at least 3 months in the home environment. Quality of life was assessed by EQ-5D-3L questionnaire and Liverpool PEG questionnaire, while nutritional status was assessed with the Malnutrition Universal Screening Tool (MUST). Statistical data analysis was done by statistical software MedCalc (Ostend, Belgium; version 11.5.1.0) for Windows.
Results: The study included 21 male and 10 female patients who are enterally feeding via percutaneous endoscopic gastrostomy tube in the home environment. The median body mass index (BMI) was 22.5 kg/m2 (Q1-Q3: 18.6-24.4; min-max: 12.1-30.7). Low, medium and high risks of malnutrition among participants were 52%, 19% and 29%, respectively. If the high risk of malnutrition is compared with the other combined risks of malnutrition (combined low and medium risks), it turns out that the high risk is 2.44 times lower than the other risks (x2 = 5.7, P = 0.017). The mean value of the EQ-VAS score was 37.3 ± 29; the median value was 30 (Q1-Q3: 10-50; min-max: 1-99) (95% CI: 20-50). The percentage of patients who wanted to remove PEG in the group with EQ VAS score > 30 was 61% (n = 8). This was 5.5 times more than the percentage of patients (11%; n = 2) who wanted to remove PEG in the group with EQ VAS score ≤30 (P = 0.006). Percentage of patients who were thinking that PEG did not affect their overall quality of life was 4.3 times higher. The proportion of patients who were thinking that PEG does not affect their overall quality of life is 81% (95% CI: 63-95).
Conclusion: The high overall risk of malnutrition is statistically significantly lower compared to the combined low and medium overall risks of malnutrition among patients who are enterally feeding via percutaneous endoscopic gastrotomy tube in the home environment. Based on this research, it could be concluded that the population of patients who are enterally feeding via PEG in the home environment estimate the median health-related quality of life between 20 and 50 according to EQ VAS score with 95% probability. Patients who had a better overall health-related quality of life according to the EQ VAS score were more prone to the option of removing the PEG. The majority of patients who are enterally feeding via PEG in the home environment report that PEG does not affect their overall quality of life. |
Sažetak (hrvatski) | Ciljevi: Procijeniti nutritivni status i kvalitetu života bolesnika koji se enteralno hrane putem perkutane endoskopske gastrostome u razdoblju od najmanje 3 mjeseca u kućnom okruženju.
Materijali i metode: Ovo istraživanje obuhvatilo je ukupno 31 sudionika, u dobi od 21 do 85 godina, koji su se hranili putem perkutane endoskopske gastrostome u razdoblju od najmanje 3 mjeseca u kućnom okruženju. Kvaliteta života procijenjena je sa EQ-5D-3L upitnikom i Liverpool PEG upitnikom, dok je nutritivni status procijenjen sa Malnutrition Universal Screening Tool (MUST) upitnikom. Statistička analiza podataka napravljena je statističkim softverom MedCalc (Ostend, Belgija; verzija 11.5.1.0) za Windows.
Rezultati: Istraživanje je obuhvatilo 21 muškog i 10 ženskih bolesnika koji se enteralno hrane putem perkutane endoskopske gastrostome u kućnim uvjetima. Medijan indeksa tjelesne mase (BMI) bio je 22,5 kg/m2 (Q1-Q3: 18,6-24,4; min-max: 12,1-30,7). Niski, srednji i visoki rizici od pothranjenosti među sudionicima bili su 52%, 19% i 29%. Ako se visoki rizik od pothranjenosti usporedi s ostalim kombiniranim rizicima pothranjenosti (kombinirani niski i srednji rizici), uočava se da je visoki rizik 2,44 puta manji od ostalih rizika (x2 = 5,7, P = 0,017). Srednja vrijednost EQ-VAS rezultata bila je 37,3 ± 29; medijan je bio 30 (Q1-Q3: 10-50; min-max: 1-99) (95% CI: 20-50). Postotak pacijenata koji su htjeli ukloniti PEG u skupini s EQ VAS rezultatom > 30 bio je 61% (n = 8). To je bilo 5,5 puta više od postotka pacijenata (11%; n = 2) koji su željeli ukloniti PEG u skupini s EQ VAS rezultatom ≤30 (P = 0,006). Postotak pacijenata koji su smatrali da PEG ne utječe na njihovu ukupnu kvalitetu života bio je 4,3 puta veći. Udio pacijenata koji su mislili da PEG ne utječe na njihovu ukupnu kvalitetu života je 81% (95% CI: 63-95).
Zaključci: Visoki ukupni rizik od pothranjenosti statistički je značajno niži u usporedbi s kombiniranim niskim i srednjim ukupnim rizikom od pothranjenostiu pacijenata koji se enteralno hrane putem perkutane endoskopske gastrostome u kućnom okruženju. Na temelju ovog istraživanja može se zaključiti da populacija pacijenata koji se enteralno hrane putem PEG-a u kućnom okruženju procjenjuju medijan kvalitete života povezane sa zdravljem između 20 i 50 prema EQ VAS rezultatu s 95% vjerojatnosti. Pacijenti koji su imali bolju ukupnu kvalitetu života povezanu sa zdravljem prema EQ VAS rezultatu bili su skloniji opciji uklanjanja PEG-a. Većina pacijenata koji se enteralno hrane preko PEG-a u kućnom okruženju navodi da PEG ne utječe na njihovu ukupnu kvalitetu života. |