Page 108 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

Children with cardiac disease had lower HRQoL after GP, with a mean difference of -19.0 points (-32.1 – -5.9) between affected and unaffected children. In addition, children with a history of gastrointestinal surgery (mean difference of -15.2 points, (-28.2 – -1.7)) and older patients at time of operation (-1.2 points per year; (-2.3 – -0.2)) had lower HRQoL.
The need for jejunal tube feeding at the gastrostomy site was also a predictor of lower HRQoL, with a mean difference of -33.0 between children with and children without the need for jejunal tube feeding (-9.3 – -56.7).
The other variables included in the analysis did not have a statistically significant predictive value on postoperative HRQoL.
Table 4. Results of the multiple linear regression analysis of health-related quality of life after gastrostomy placement (n=150).
Predictors of health-related quality of life*
Mean difference (95% confidence interval)
p-value
Patient characteristics
Age (years)
-1.2 (-2.3 – -0.2)
0.03
Gender (female)
-5.5 (-16.3 – 5.3)
0.32
Follow-up time (years)
-0.2 (-3.8 – 3.5)
0.93
Medical history
Neurologic impairment
-21.4 (-32.6 – -10.3)
<0.001
Cardiac disease
-19.0 (-32.1 – -5.9)
0.01
Previous gastrointestinal surgery
-15.2 (-28.2 – -1.7)
0.03
Gastroesophageal reflux
-4.3 (-13.5 – 5.0)
0.37
Acid exposure time (%) on 24-hour pH- monitoring
-0.4 (-1.5 – 0.7)
0.48
Gastrostomy-related factors
Jejunal feeding
-33.0 (-9.3 – -56.7)
0.01
Reinterventions in operating theater
-16.2 (-33.2 – 0.8)
0.06
Legend: * Predictors: indicating that positive predictors are correlated with better outcome in health-related quality of life.
DisCUssion
This was the first study to investigate HRQoL in children with a gastrostomy using validated questionnaires. We found that after a mean follow-up time of 4.0 years (IQR 2.9 – 6.2), children with a gastrostomy had significantly lower HRQoL compared to the HRQoL of a large population of healthy normal children. Although it was suspected that HRQoL would be affected in this group of children, this had not previously been demonstrated.
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