Point Prevalence of Gastrostomy in a Paediatric Population. Issue 4 (April 2021) - Pardy, Caroline
ABSTRACT: Objective: The aim of the study was to determine the prevalence of gastrostomy in a paediatric population. Methods: A population-based cross-sectional point prevalence study of paediatric gastrostomy was performed. Patients included were ages 0 to 19 years, living within 3 inner-city London boroughs; Southwark, Lambeth, and Lewisham. Patients were identified as having a gastrostomy in situ via Home Enteral Nutrition (HEN) and community nursing databases. Electronic healthcare records were scrutinised to confirm current use of a gastrostomy. The main outcome measures were the point prevalence of gastrostomy in the paediatric population (gastrostomies/100, 000 children), primary diagnosis, indication underlying gastrostomy insertion, and age at insertion. Results: The total population studied was 946, 709, of whom 213, 920 were of age 0 to 19 years. Of these, 179 had a gastrostomy in situ giving a point prevalence for gastrostomy in the paediatric population of 83.7 (95% confidence interval [CI]: 71.4–96.0)/100, 000 children. This varied between age groups: 0 to 4 years: 79.6 (57.3–102.0)/100, 000, 5 to 9 years: 116.3 (88.7–143.9)/100, 000, 10 to 14: years 87.9 (61.9–113.9)/100, 000 and 15 to 19: years 41.4 (22.1–60.1)/100, 000. The most common primary diagnoses were neurological disorders (57.1%), and structural abnormalities (16.2%). Unsafe swallow was the most common indication (61%), followed by nutritional or fluid supplementation (28.6%), and behavioural reasons (8.7%). The majority (85.1%) of gastrostomies were inserted under the age of 2 years. Conclusions: This is the first UK population-based study of paediatric gastrostomy, identifying a point prevalence of 84/100, 000 children. The peak prevalence is in children ages 5 to 9 years. Gastrostomy insertion after a child reaches school age is uncommon. Abstract : Supplemental Digital Content is available in the text