Nutrición por gastrostomía y desarrollo de infecciones respiratorias bajas en adultos sin ventilación mecánica: un estudio de cohorte prospectiva
Cortés Muñoz, Fabián
Guevara Cruz, Oscar A.
Revista colombiana de gastroenterologia, 0120-9957, Vol. 28, Nro. 4, 2013, p. 301-309
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Nosocomial lower respiratory infections are the most frequent and expensive nosocomial infections in general medical and surgical services, and they are the ones which have the greatest impacts on patients health. Some risk factors and some protective factors have been clearly identifi ed while others have others have been associated since they are present in greater frequency among those affected. One of these is percutaneous endoscopic gastrostomy (PEG) feeding. The objectives of this study were to determine the association between PEG feeding and the development of lower respiratory tract infections in adult patients without mechanical ventilation and to model risk as a function of time. This study wasa prospective cohort study with follow-up of patients in the hospital and at home for 90 days. Gastrostomyfed patients and patients without PEG feeding were studied to determine whether lower respiratory infectionsdeveloped. The Kaplan Meier estimator and Cox proportional hazards model were used for statistical analysis of data. A total of 128 subjects, two cohorts of 64 patients each, were included. 62.5% of the patients with PEG feeding and 32.8% of those without PEG feeding developed lower respiratory infections duringfollow-up (p = 0.0008). PEG feeding increased the risk of developing lower respiratory infections by 180%(HR 2.8, 95% CI 1.64 - 4.77, p=0.0001) over the risk of patients without PEG feeding. This associationincreased when adjusted for confounding variables and interaction (HR 4.6, 95% CI 1.95 - 8.42, p=0.0000). PEG feeding represents a risk factor for the development of lower respiratory tract infections inadults without mechanical ventilation. This risk varies over time.
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