Survival of children and adolescents with intellectual disability following gastrostomy insertion
Background: Positive health outcomes have been observed following gastrostomy insertion in children with intellectual disability, which is being increasingly used at younger ages to improve nutritional intake. This study investigated the effect of gastrostomy insertion on survival of children with s...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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WILEY
2020
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1103746 http://hdl.handle.net/20.500.11937/86754 |
| _version_ | 1848764861828300800 |
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| author | Wong, K. Glasson, E.J. Jacoby, P. Srasuebkul, P. Forbes, D. Ravikumara, M. Wilson, A. Bourke, J. Trollor, J. Leonard, H. Nagarajan, L. Downs, Jennepher |
| author_facet | Wong, K. Glasson, E.J. Jacoby, P. Srasuebkul, P. Forbes, D. Ravikumara, M. Wilson, A. Bourke, J. Trollor, J. Leonard, H. Nagarajan, L. Downs, Jennepher |
| author_sort | Wong, K. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Positive health outcomes have been observed following gastrostomy insertion in children with intellectual disability, which is being increasingly used at younger ages to improve nutritional intake. This study investigated the effect of gastrostomy insertion on survival of children with severe intellectual disability.
Methods: We used linked disability and health data of children and adolescents who were born in Western Australia between 1983 and 2009 to compare survival of individuals with severe intellectual disability by exposure to gastrostomy status. For those born in 2000–2009, we employed propensity score matching to adjust for confounding by indication. Effect of gastrostomy insertion on survival was compared by pertinent health and sociodemographic risk factors.
Results: Compared with children born in the 1980s–1990s, probability of survival following first gastrostomy insertion for those born in 2000–2009 was higher (2 years: 94% vs. 83%). Mortality risk was higher in cases than that in their matched controls (hazard ratio 2.9, 95% confidence interval 1.1, 7.3). The relative risk of mortality (gastrostomy vs. non-gastrostomy) may have differed by sex, birthweight and time at first gastrostomy insertion. Respiratory conditions were a common immediate or underlying cause of death among all children, particularly among those undergoing gastrostomy insertion.
Conclusions: Whilst gastrostomy insertion was associated with lower survival rates than children without gastrostomy, survival improved with time, and gastrostomy afforded some protection for the more vulnerable groups, and earlier use appears beneficial to survival. Specific clinical data that may be used to prioritise the need for gastrostomy insertion may be responsible for the survival differences observed. |
| first_indexed | 2025-11-14T11:26:05Z |
| format | Journal Article |
| id | curtin-20.500.11937-86754 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:26:05Z |
| publishDate | 2020 |
| publisher | WILEY |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-867542022-01-05T04:18:11Z Survival of children and adolescents with intellectual disability following gastrostomy insertion Wong, K. Glasson, E.J. Jacoby, P. Srasuebkul, P. Forbes, D. Ravikumara, M. Wilson, A. Bourke, J. Trollor, J. Leonard, H. Nagarajan, L. Downs, Jennepher Social Sciences Science & Technology Life Sciences & Biomedicine Education, Special Genetics & Heredity Clinical Neurology Psychiatry Rehabilitation Education & Educational Research Neurosciences & Neurology enteral feeding mortality nutrition paediatric survival PERCUTANEOUS ENDOSCOPIC GASTROSTOMY DEVELOPMENTAL-DISABILITY WESTERN-AUSTRALIA CEREBRAL-PALSY DATA LINKAGE OUTCOMES MORTALITY EVENT BIAS Background: Positive health outcomes have been observed following gastrostomy insertion in children with intellectual disability, which is being increasingly used at younger ages to improve nutritional intake. This study investigated the effect of gastrostomy insertion on survival of children with severe intellectual disability. Methods: We used linked disability and health data of children and adolescents who were born in Western Australia between 1983 and 2009 to compare survival of individuals with severe intellectual disability by exposure to gastrostomy status. For those born in 2000–2009, we employed propensity score matching to adjust for confounding by indication. Effect of gastrostomy insertion on survival was compared by pertinent health and sociodemographic risk factors. Results: Compared with children born in the 1980s–1990s, probability of survival following first gastrostomy insertion for those born in 2000–2009 was higher (2 years: 94% vs. 83%). Mortality risk was higher in cases than that in their matched controls (hazard ratio 2.9, 95% confidence interval 1.1, 7.3). The relative risk of mortality (gastrostomy vs. non-gastrostomy) may have differed by sex, birthweight and time at first gastrostomy insertion. Respiratory conditions were a common immediate or underlying cause of death among all children, particularly among those undergoing gastrostomy insertion. Conclusions: Whilst gastrostomy insertion was associated with lower survival rates than children without gastrostomy, survival improved with time, and gastrostomy afforded some protection for the more vulnerable groups, and earlier use appears beneficial to survival. Specific clinical data that may be used to prioritise the need for gastrostomy insertion may be responsible for the survival differences observed. 2020 Journal Article http://hdl.handle.net/20.500.11937/86754 10.1111/jir.12729 English http://purl.org/au-research/grants/nhmrc/1103746 http://purl.org/au-research/grants/nhmrc/1117105 WILEY fulltext |
| spellingShingle | Social Sciences Science & Technology Life Sciences & Biomedicine Education, Special Genetics & Heredity Clinical Neurology Psychiatry Rehabilitation Education & Educational Research Neurosciences & Neurology enteral feeding mortality nutrition paediatric survival PERCUTANEOUS ENDOSCOPIC GASTROSTOMY DEVELOPMENTAL-DISABILITY WESTERN-AUSTRALIA CEREBRAL-PALSY DATA LINKAGE OUTCOMES MORTALITY EVENT BIAS Wong, K. Glasson, E.J. Jacoby, P. Srasuebkul, P. Forbes, D. Ravikumara, M. Wilson, A. Bourke, J. Trollor, J. Leonard, H. Nagarajan, L. Downs, Jennepher Survival of children and adolescents with intellectual disability following gastrostomy insertion |
| title | Survival of children and adolescents with intellectual disability following gastrostomy insertion |
| title_full | Survival of children and adolescents with intellectual disability following gastrostomy insertion |
| title_fullStr | Survival of children and adolescents with intellectual disability following gastrostomy insertion |
| title_full_unstemmed | Survival of children and adolescents with intellectual disability following gastrostomy insertion |
| title_short | Survival of children and adolescents with intellectual disability following gastrostomy insertion |
| title_sort | survival of children and adolescents with intellectual disability following gastrostomy insertion |
| topic | Social Sciences Science & Technology Life Sciences & Biomedicine Education, Special Genetics & Heredity Clinical Neurology Psychiatry Rehabilitation Education & Educational Research Neurosciences & Neurology enteral feeding mortality nutrition paediatric survival PERCUTANEOUS ENDOSCOPIC GASTROSTOMY DEVELOPMENTAL-DISABILITY WESTERN-AUSTRALIA CEREBRAL-PALSY DATA LINKAGE OUTCOMES MORTALITY EVENT BIAS |
| url | http://purl.org/au-research/grants/nhmrc/1103746 http://purl.org/au-research/grants/nhmrc/1103746 http://hdl.handle.net/20.500.11937/86754 |