To the Editor: The article by Calver and colleagues on the use of gastrostomy tubes in older Western Australians raises important issues regarding decision making for gastrostomy tube insertion and ongoing care of gastrostomy-fed patients. Calver et al report a high incidence of readmissions within 1 year for gastrostomy tube replacement or gastrostomy-related complication (25%) and a high 1-year mortality rate (54%)1 Extrapolation of New South Wales data suggests that about 11 000 Australians rely on gastrostomy feeding at home as their sole source of nutrition and hydration.2
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- 1 Greater Metropolitan Clinical Taskforce, Sydney, NSW.
- 2 Sydney West Area Health Service, Sydney, NSW.
- 3 Central Hospital Network, South Eastern Sydney Area Health Service, Sydney, NSW.
- 1. Calver J, McCaul KA, Burmas M, et al. Use of gastrostomy tubes in older Western Australians: a population-based study of frequency, indications and outcomes. Med J Aust 2009; 190: 358-361. <MJA full text>
- 2. Home Enteral Nutrition Network. Home enteral nutrition report: nourishing lives at home. Sydney: Greater Metropolitan Clinical Taskforce, 2007. http://www.health.nsw.gov.au/resources/gmct/hen/hen_report_2007_pdf.asp (accessed Jul 2009).
- 3. NSW Ombudsman. Report of reviewable deaths in 2006. Volume 1: deaths of people with disabilities in care. Sydney: NSW Ombudsman, 2007.