Complications of gastrostomy tube placement in patients with dementia: a national inpatient analysis

Background: Gastrostomy tubes have not been shown to improve long-term outcomes in patients with dementia, yet the risk of short-term complications have not been well characterized in this population. Methods: This is a cross-sectional retrospective assessment of the National Inpatient Sample from 2016 to 2022. We compared outcomes in patients with dementia and those without dementia. Evaluated outcomes including procedural complications, in-hospital mortality, and discharge to home among others. Assessed procedural complications included peritonitis, hemorrhage, infection and colon perforation. Results: A total of 1,171,230 hospitalizations were identified, 241,380 (20.6%) were for patients with dementia. Patients with dementia were older (mean 76.3 vs 64.1 years, p < 0.001), more likely to be female (49.4% vs 41.7%, p < 0.001) and Black (27.5% vs 19.6%, p < 0.001). Procedural complications were less common in patients with dementia (3.6% vs 4.6%, ARD = 10:1000) although surgical site infection was increased (1.6% vs 1.4%, aOR = 1.58, 95% CI 1.44–1.73, p < 0.001). Mortality was also decreased in patients with dementia (6.4% vs 8.2%, ARD = 19:1000). Patients with dementia were less likely to discharge to home (20.8% vs 33.8%, aOR = 0.64, 95% CI 0.63–0.66, p < 0.001). Conclusions: Gastrostomy tube placement complications do not appear to be increased in patients with dementia. However, those who undergo gastrostomy tube placement are less likely to discharge to home which has important quality of life implications.