A cross-sectional and longitudinal study of health-related quality of lifeafter percutaneous gastrostomy

Objective Although gastrostomy feeding tends to have fewer interruptions th an naso-gastric feeding and is cosmetically more acceptable; there is littl e information on health-related quality of life (HRQoL) in these patients. This study aimed to measure the health-related quality of life of patients after gastrostomy placement Design Cross-sectional and prospective cohorts. Setting Institutional and community-dwelling patients receiving nutritional support via a gastrostomy. Participants For the cross-sectional cohort, all individuals who have recei ved a percutaneous gastrostomy from our unit (January 1994-December 1996) w ere included; 55 of the 102 patients who were still living agreed to follow -up assessment For the prospective cohort, all patients referred to our uni t for percutaneous gastrostomy (March 1997-June 1998) were eligible to part icipate; 54 of 88 patients (62%) consented and were recruited. Methods and outcome measures A cross-sectional assessment of patient outcom e and health-related quality of life using SF-36, the Hospital Anxiety and Depression Scale and a disease-specific questionnaire (PEG-QU) was carried out in patients in primary health care after receiving a gastrostomy, These assessments, plus the Modified Rankin Scale, were performed on patients st udied at the time of gastrostomy placement, and after 1, 6 and 12 months of follow-up, Results HRQoL questionnaires could be answered in less than half the patien ts. An overall rating of the effect of the gastrostomy on the patients' and carers' HRQoL showed a positive effect in 55% and 80%, respectively. A pos itive impression of the gastrostomy by the patient did not necessarily refl ect an improvement in their nutritional status. Assessment of HRQoL in a co hort of gastrostomy patients showed deficiencies in the physical domain but not mental function (anxiety or depression), energy or health perception. Neither physical function nor level of cognition at time of gastrostomy pla cement appear to be able to predict patient survival. Nutritional outcome w as not related to HRQoL outcome. Conclusion The majority of patients and carers rate gastrostomy positively. Patients who were 75 years or older had a poorer survival compared to youn ger patients, but gender, physical or cognitive function had no predictive value on survival, (C) 2000 Lippincott Williams & Wilkins.