Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Original Article

Volume 5, Number 1, February 2012, pages 10-20


The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia

Tables

Table 1. The Level of Independent Living of Demented Elderly
 
IDaily living is almost independent in family and community
IIThere are some difficulties in daily life due to dementia-specific signs, behavior and communication, but the person can live independently with someone.
  IIaThe difficulties are observed outside of home
  IIbThe difficulties are observed inside of home
IIIDifficulties in daily life due to dementia-specific signs, behavior and communication are sometimes observed, and the person needs care by someone.
  IIIaThe difficulties are observed outside of home
  IIIbThe difficulties are observed inside of home
IVDifficulties in daily life due to dementia-specific signs, behavior and communication are frequently observed, and the person always needs care by someone.
MDue to serious mental illness and problematic behavior or diseases, the person needs medical care by specialists.

 

Table 2. Patients’ Characteristics at Making PEG Stratified by the Level of Independent Living of Demented Elderly
 
VariableTotal (N = 879)Improved (N = 75)Not improved (N = 804)P-value
*1. Student’s t-test was applied because the distribution was considered as normal. *2. Mann-Whitney U test was applied because the distribution was considered as not normal. *3. Chi-square test was applied.
Age (years) mean ± s.d.81.8 ± 9.479.5 ± 13.082.0 ± 8.90.02*1
Body Temperature (°C) mean ± s.d.36.8 ± 0.636.8 ± 0.536.8 ± 0.60.68*1
WBC ( /uL)7026 ± 25677354 ± 25936995 ± 25640.12*2
CRP (mg/dL)1.86 ± 2.401.81 ± 2.101.87 ± 2.420.73*2
Hb (g/dL)11.1 ± 1.911.2 ± 1.911.1 ± 1.90.49*2
ALT (IU/L)29.8 ± 26.525.8 ± 12.530.2 ± 27.40.46*2
BUN (mg/dL)21.6 ± 13.720.7 ± 12.221.8 ± 14.10.60*2
Cr (mg/dL)0.84 ± 1.150.80 ± 0.860.85 ± 1.210.05*2
Albumin (g/dL)3.01 ± 0.573.03 ± 0.583.01 ± 0.550.88*2
Total cholesterol (mg/dL)157.2 ± 40.8162.3 ± 38.6156.0 ± 41.20.58*2
male359 (41%)32 (43%)327 (40%)0.70*3
Previous history of pneumonia587 (68%)50 (68%)537 (68%)0.94*3
Hypertension348 (40%)35 (47%)313 (39%)0.18*3
Dyslipidemia77 (9%)9 (13%)68 (9%)0.28*3
Arteriosclerosis obliterans31 (3.7%)5 (6.9%)26 (3.4%)0.14*3
Able to take perorally324 (37%)31 (41%)293 (37%)0.44*3
Diabetes124 (14%)11 (15%)113 (14%)0.90*3
Previous history of cardiovascular disease134 (16%)12 (16%)122 (16%)0.91*3
Extremely poor nutritional status170 (20%)16 (22%)154 (19%)0.66*3
Fasting period prior to operation0.72*3
None189 (28%)12 (25%)177 (29%)
Within one week292 (44%)24 (50%)268 (43%)
Within one month177 (27%)12 (25%)165 (27%)
More than one month8 (1.2%)0 (0%)8 (1.3%)
Alzheimer’s dementia292 (33%)27 (36%)265 (33%)0.56*3
Cerebrovascular dementia554 (63%)43 (57%)511 (63%)0.33*3
Dementia with Lewy bodies15 (1.7%)1 (1.3%)14 (1.7%)0.80*3

 

Table 3. Improvement of the Level of Independent Living Stratified by the Level of Independent Living at Making PEG
 
VariableIIIa/IIbIIIa/IIIb/IVM
*Odds Ratio was adjusted with age, which was associated with the outcome.
No. of improved patients/no. of total patients (%)0/2 (0)8/32 (25)32/375 (8.6)7/57 (12)
Odds Ratio (95% confidence interval)*-3.9011.36
P-value(1.59 - 9.39)(0.56 - 3.30)
0.0030.50

 

Table 4. Patients’ Characteristics at Making PEG Stratified by the Improvement of Peroral Intake
 
VariableTotal (N = 961)Improved (N = 177)Not improved (N = 784)P-value
*1. Student’s t-test was applied because the distribution was considered as normal. *2. Mann-Whitney U test was applied because the distribution was considered as not normal. *3. Chi-square test was applied.
(Age years) mean ± s.d.81.7 ± 9.380.6 ± 11.182.0 ± 8.80.07*1
Body Temperature (°C) mean ± s.d.36.8 ± 0.636.8 ± 0.636.8 ± 0.60.12*1
WBC ( /µL)7041 ± 27026869 ± 23647080 ± 27730.62*2
CRP (mg/dL)1.90 ± 2.381.69 ± 2.081.95 ± 2.450.39*2
Hb (g/dL)11.6 ± 1.911.1 ± 2.111.1 ± 1.90.99*2
ALT (IU/L)30.4 ± 28.729.6 ± 34.730.6 ± 27.20.13*2
BUN (mg/dL)21.5 ± 13.821.3 ± 14.921.5 ± 13.70.94*2
Cr (mg/dL)0.83 ± 1.160.70 ± 0.360.84 ± 1.200.09*2
Albumin (g/dL)3.02 ± 0.573.03 ± 0.463.02 ± 0.580.52*2
Total cholesterol (mg/dL)157.5 ± 40.6160.7 ± 37.1157.2 ± 40.80.14*2
male396 (41%)66 (37%)330 (42%)0.24*3
Previous history of pneumonia645 (68%)107 (62%)538 (70%)0.051*3
Hypertension389 (41%)78 (45%)311 (40%)0.29*3
Dyslipidemia88 (10%)30 (17%)58 (8%)< 0.001*3
Arteriosclerosis obliterans31 (3.4%)8 (4.7%)23 (3.1%)0.29*3
Able to take perorally350 (37%)95 (54%)255 (33%)< 0.001*3
Diabetes150 (16%)35 (20%)115 (15%)0.093*3
Previous history of cardiovascular disease152 (16%)29 (17%)123 (16%)0.80*3
Extremely poor nutritional status189 (20%)39 (22%)147 (19%)0.34*3
Fasting period prior to operation0.11*3
None216 (30%)46 (34%)170 (29%)
  Within one week316 (43%)65 (47%)251 (42%)
  Within one month188 (26%)25 (18%)163 (27%)
  More than one month12 (1.6%)1 (0.7%)11 (1.9%)
Alzheimer’s dementia310 (32%)76 (43%)234 (30%)0.001*3
Cerebrovascular dementia610 (63%)95 (53%)515 (65%)0.003*3
Dementia with Lewy bodies18 (1.9%)2 (1.1%)16 (2.0%)0.42*3

 

Table 5. Improvement of Peroral Intake Stratified by the Level of Independent Living at Making PEG
 
VariableIIIa/IIbIIIa/IIIb/IVM
*Odds Ratio was adjusted with dyslipidemia, able to take perorally, Alzheimer’s dementia, and cerebrovascular dementia, which were associated with the outcome.
No. of improved patients/no. of total patients (%)1/2 (50)12/34(35)70/419 (17)13/62 (21)
Odds Ratio (95% confidence interval)*-2.6911.39
P-value(1.17 – 6.17)(0.70 -2.77)
0.020.35

 

Table 6. Patients’ Characteristics at Making PEG Stratified by the Improvement of Pneumonia
 
VariableTotal (N = 777)Improved (N = 557)Not improved (N = 220)P-value
*1. Student’s t-test was applied because the distribution was considered as normal. *2. Mann-Whitney U test was applied because the distribution was considered as not normal. *3. Chi-square test was applied.
Age (years) mean ± s.d.82.1 ± 9.082.1 ± 9.381.9 ± 8.40.73*1
Body Temperature (°C) mean ± s.d.36.8 ± 0.636.8 ± 0.636.8 ± 0.60.79*1
WBC (/µL)7101 ± 27457222 ± 28476797 ± 24540.08*2
CRP (mg/dL)2.01 ± 2.452.00 ± 2.432.05 ± 2.040.85*2
Hb (g/dL)11.0 ± 1.911.0 ± 1.810.9 ± 2.00.47*2
ALT(IU/L)30.7 ± 29.530.6 ± 30.730.7 ± 26.40.60*2
BUN (mg/dL)21.5 ± 13.421.3 ± 12.721.8 ± 14.90.63*2
Cr (mg/dL)0.84 ± 1.150.85 ± 1.170.83 ± 1.090.92*2
Albumin (g/dL)2.98 ± 0.582.97 ± 0.543.01 ± 0.680.69*2
Total cholesterol (mg/dL)155.5 ± 40.3154.5 ± 40.1158.1 ± 40.80.29*2
male343 (44%)240 (43%)103 (46%)0.38*3
Previous history of pneumonia628 (81%)480 (86%)148 (69%)<0.001*3
Hypertension315 (41%)225 (41%)90 (41%)0.99*3
Dyslipidemia73 (10%)61 (11%)12 (6%)0.015*3
Arteriosclerosis obliterans28 (3.8%)19 (3.6%)9 (4.2%)0.70*3
Able to take perorally270 (35%)188 (34%)82 (38%)0.29*3
Diabetes113 (15%)93 (17%)20 (9%)0.006*3
Previous history of cardiovascular disease121 (16%)98 (18%)23 (11%)0.01*3
Extremely poor nutritional status158 (21%)106 (20%)52 (24%)0.20*3
Fasting period prior to operation
None170 (29%)130 (32%)40 (24%)
Within one week244 (42%)147 (36%97 (57%)
Within one month159 (27%)130 (32%)29 (17%)
More than one month
Alzheimer’s dementia248 (32%)182 (33%)66 (30%)0.45*3
Cerebrovascular dementia484 (62%)340 (61%)144 (65%)0.28*3
Dementia with Lewy bodies13 (1.7%)10 (1.8%)3 (1.4%)0.67*3

 

Table 7. Improvement of Pneumonia Stratified by the Level of Independent Living at Making PEG
 
VariableIIIa/IIbIIIa/IIIb/IVM
*Odds Ratio was adjusted with previous history of pneumonia, dyslipidemia, diabetes, previous history of cardiovascular disease and fasting period prior to operations, which were associated with the outcome.
No. of improved patients/no. of total patients (%)1/1 (100)18/27 (67)229/351 (65)30/50 (60)
Odds Ratio (95% confidence interval)*-1.3310.61
P-value(0.45 - 3.89)(0.28 - 1.31)
0.600.20

 

Table 8. Cox Proportional Hazard Models
 
VariableSingle-variate analysesMultivariate analysis
Crude HR95% CIP valueAHR95% CIP value
*Adjusted for all the variables listed in the table. HR, hazard ratio; CI, confidence interval; AHR, adjusted hazard ratio.
Age (year)1.031.02 - 1.04< 0.0011.041.02 - 1.06< 0.001
Body mass index (kg/m2)0.960.93 - 0.990.040.980.94 - 1.030.46
Body Temperature (°C)0.930.80 - 1.090.39
WBC (/uL)1.000.99 - 1.000.31
CRP (mg/dL)1.071.03 - 1.10< 0.0011.000.95 - 1.060.86
Hb (g/dL)0.880.84 - 0.92< 0.0011.030.94 - 1.140.48
ALT (IU/L)1.001.00 - 1.010.0011.000.99 - 1.010.10
BUN (mg/dL)1.021.01 - 1.02< 0.0011.021.01 - 1.03< 0.001
Cr (mg/dL)1.040.98 - 1.110.230.940.84 - 1.060.30
Albumin (g/dL)0.640.55 - 0.76< 0.0010.510.36 - 0.73< 0.001
Total cholesterol (mg/dL)0.990.99 - 1.000.0011.000.99 - 1.000.90
Male1.561.31 - 1.86< 0.0012.011.49 - 2.92< 0.001
Previous history of pneumonia1.421.16 - 1.730.0011.100.79 - 1.540.56
level of independent living of demented elderly1.050.97 - 1.150.25
Hypertension1.170.98 - 1.390.09
Dyslipidemia1.200.91 - 1.600.20
Arteriosclerosis obliterans1.210.78 - 1.880.39
Able to take perorally0.760.63 - 0.920.0040.820.59 - 1.120.21
Diabetes1.611.29 - 1.990.102.171.46 - 3.25< 0.001
Previous history of cardiovascular disease1.451.16 - 1.810.0011.090.73 - 1.650.67
Extremely poor nutritional status1.401.13 - 1.730.0021.310.92 - 1.880.14
Fasting period prior to operation1.050.98 - 1.110.14
Alzheimer’s dementia0.930.78 - 1.120.47
Cerebrovascular dementia1.170.98 - 1.410.08
Dementia with Lewy bodies0.810.40 - 1.630.55
Level of independent living
  I--
  IIa/IIb0.590.34 - 1.00
  IIIa/IIIb--
  M1.030.72 - 1.47