Article Text

Gastrostomy and weight velocity in South Northamptonshire children: a preliminary enquiry
  1. R Sharma,
  2. AN Williams
  1. Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK


Introduction Children with a neurodisability grow poorly adversely affecting health and societal participation1. Recent evidence suggests that gastrostomy feeding significantly improved growth and general health in this group of children2. This study's aim was to quantify the weight velocity, z-score and general health of such children pre- and post-gastrostomy insertion.

Method Weight data on children with a primary neurodisability was obtained from school and case-note growth charts pre-and post-gastrostomy. Children with brain neoplasia, undergoing chemotherapy, radiotherapy or palliated were excluded. A linear model of weight velocity was applied to the data and validated against Centre for Disease Control (CDC) charts3. Weight velocities and z-scores pre- and post-gastrostomy insertion were compared to CDC data. Number of acute admissions to local hospital one year pre- and post-gastrostomy was used as a health outcome. Data was analysed using SPSSv20.

Results 30 children with neurodisability and gastrostomy were identified. 43% male, 57% female. Mean age at gastrostomy was 38.3 months (SD=35.7 months). There was no significant difference in admission rates pre- and post-gastrostomy (p=0.577).There was no significant increase in absolute weight velocity post-gastrostomy (p=0.156). Weight velocity difference pre- and post-gastrostomy was greater and more positive than that expected in normal growth according to CDC data (p=0.015). There was a significant increase in z-score post-gastrostomy (p=0.001) from mean z-score= −1.57 (SD=1.8) to mean z-score= −0.83 (SD=1.67). Gastrostomy insertion at younger age was positively correlated with a greater increase in z-score post-gastrostomy insertion (R=−0.391).

Conclusion The patient group selected for gastrostomy has widened over the last decade. In our analysis gastrostomy insertion increases weight velocity above that expected for the normal population and results in a significant increase in z-score. Gastrostomy insertion at a younger age results in greater percentile weight gain.

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