Factors influencing gastrostomy tube feeding duration and nutrition outcomes in pediatric patients with Down syndrome: A descriptive cohort study

Abstract

AbstractBackgroundFeeding difficulty is widely recognized in patients with Down syndrome, and many patients require gastrostomy tube (G‐tube) placement for nutrition. No reliable factors have been identified to predict the expected duration of G‐tube feeds in patients with Down syndrome. This descriptive cohort study aimed to determine the factors affecting the duration of G‐tube feeds. We also investigated change in body mass index (BMI) from G‐tube placement to discontinuation.MethodsMedical records of patients with Down syndrome seen by a pediatric gastroenterologist at a tertiary care center between September 1986 and December 2021 were reviewed. Data collection included demographics, anthropometrics, comorbidities, and feeding route. Comparison was performed between patients who discontinued G‐tube feeds and those who did not.ResultsTwo hundred twenty patients (45% female) were included. The median age at G‐tube placement was 5 months (interquartile range [IQR]: 0.2–1.3 years). There were 113 (51%) patients who discontinued G‐tube feeds, after a median duration of 31.6 months (IQR: 15.6–55.7 months). Tracheostomy was the only covariant associated with a longer duration of G‐tube feeds (158 months vs 53 months; P = 0.002). Neither age at G‐tube placement nor any comorbidities were associated with BMI status at discontinuation of G‐tube.ConclusionIn our cohort of patients with Down syndrome, age at placement of G‐tube did not impact the duration of G‐tube feeds. Most patients who had a G‐tube placed were likely to require enteral feeds for at least 1 year. Those who had a tracheostomy needed their G‐tube for a longer time.