Abstract Details

Title Early Gastrostomy Versus Late Gastrostomy Tube Performed in ALS Patients Admitted with Aspiration Pneumonia in the United States

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P6 - Poster Session 6 (8:00 AM-9:00 AM)

Poster/Presentation
Number 11-002

Objective

Aspiration pneumonia is a common complication in patients with amyotrophic lateral sclerosis (ALS). Gastrostomy tube placement in these patients is favorable for nutrition however longer length of hospitalization could lead to increased financial burden on patient population in United States.

Background To compare the clinical outcome and in-hospital complication risk with early (defined as within one week of admission) versus late (defined as after one week of admission) gastrostomy tube placement among patients with ALS.

Design/Methods

We obtained data for ALS patients admitted to hospitals in the United States from 2017 to 2019 with primary diagnosis of aspiration pneumonia using large national database. We determined the rate and pattern of utilization of associated in-hospital outcomes of gastrostomy tube placement in this patient population.

Results A total of 934 patients underwent gastrostomy tube out of which 548 (58.7%) had early gastrostomy and 386 (41.3%) had late gastrostomy tube placement. The racial differences in white, black, Hispanics, and others in early versus late gastrostomy tubes were: (73.9% vs. 63.5%, p<0.001), (8.5% versus 16.6%, p< 0.100), (8.2% vs. 11.9%, p>0.05), (9.5% vs 8.03% p>0.05) resp. No racial differences were observed in Hispanic population and other populations, however white population received early gastrostomy more than the black population. Patients who underwent late gastrostomy tube placement had more in-hospital complications including, sepsis (43.2% vs. 34.3%, p<0.01), and deep vein thrombosis (6.3% vs. 2.3%, p < 0.01). A significant difference was noticed between academic versus non-academic medical centers. Teaching hospitals performed early gastrostomies 1.4 times more than non-teaching hospitals (p<0.001). Length of stay during hospitalization was significantly lower in the early gastrostomy tube versus late gastrostomy tube groups (3.7% vs. 16.4%, p<0.01).

Conclusions The length of stay, and thus the cost of hospitalization is less in ALS patients who were admitted with aspiration pneumonia and were offered early gastrostomy tube.

Authors/Disclosures
Baljinder Singh, MD PRESENTER	Dr. Singh has nothing to disclose.
Yixin Chen	No disclosure on file
Xueying Liu	No disclosure on file
Rajeev Motiwala, MD, FAAN (NYU Langone School of Medicine)	Dr. Motiwala has nothing to disclose.
MaryLynn Chu, MD (NYU-Langone Othopedic Hospital)	Dr. Chu has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sarepta Therapeutics; PTC Therapeutics,Inc..
Harmandeep Singh Brar	No disclosure on file
Jacqueline Kraus, MD, PhD	Dr. Kraus has a non-compensated relationship as a Member with AAN that is relevant to AAN interests or activities.
Elina Zakin, MD, FAAN (NYU Grossman School of Medicine)	The institution of Dr. Zakin has received research support from American Board of Psychiatry and Neurology.

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