Tube Feeding and Lethal Aspiration in Neurological Patients: A Review of 720 Autopsy Cases

Abstract

A study of 720 autopsy cases from the Instituto Nacional de Neurologia, SSA (INN) and the Centro Hospitalario 20 de Noviembre ISSTE (CH 20 N) was made in order to investigate the frequency of aspiration in postmortem material of neurological cases. Aspiration occurred in 12.5% and 6.5%, respectively, of the cases under study. The clinical features of both groups were quite similar, and slight differences could not account for the uneven proportion of aspiration. When correlating the presence or absence of aspiration in both groups with and without the use of a gastric tube, a significant correlation was found between the use of a tube and the postmortem finding of aspiration. Gastric tube (tube feeding) increases the risk of aspiration six times. Our results support the view that opposes the early, indiscriminate and incautious use of tube feeding in the comatose patient.