Nutritional support teams increase percutaneous endoscopic gastrostomy uptake in motor neuron disease

Table 1 Summary of patient demographic and disease characteristics characteristics of subjects (mean ± SD) or n (%)

Males	49 (57)
Type of MND
Bulbar as predominant symptom	38 (44)
Limb as predominant symptom	48 (56)
Age at symptom onset (yr)	65.0 ± 13.7
Age at diagnosis (yr)	66.4 ± 13.0
Survival after PEG placement (mo)	11.3 ± 10.1
Living arrangements
Alone	13 (15)
With spouse	50 (58)
With other family member	10 (12)
Care facility	7 (8)
Not recorded	6 (7)
Complications during illness
Dysphagia	66 (77)
Respiratory insufficiency	47 (55)
Dementia	5 (6)
Symptom onset to PEG placement (mo)	20.3 ± 8.0
Diagnosis to PEG placement (mo)	10.8 ± 8.3

MND: Motor neuron disease; PEG: Percutaneous endoscopic gastrostomy.

Table 2 Relationship between the uptake of percutaneous endoscopic gastrostomy and clinician initiating discussion

	Nutritional support team	Other clinicians	P value
Initial PEG discussions, n	36	29
Patients undergoing PEG insertion after initial discussion, n	20 (56%, 20/36)	7 (24%, 7/29)	0.011
MND symptom onset to MND diagnosis, mo	12.8 (± 7.5), n = 26	8.4 (± 3.9), n = 17	0.017
MND diagnosis to initial PEG discussion, mo	5.4 (± 7.0), n = 20	11.9 (± 13.4), n = 6	0.028
Initial PEG discussion to placement, mo	3.5 (± 3.3), n = 20	4.4 (± 3.2), n = 6	0.572
PEG placement to death, mo	12.9 (± 11.1), n = 20	8.8 (± 10.1), n = 6	0.422
MND symptom onset to death, mo	30.0 (± 13.2), n = 26	31.2 (± 13.2), n = 17	0.740
MND diagnosis to death, mo	18.0 (± 15.6), n = 36	21.6 (± 15.6), n = 27	0.393

MND: Motor neuron disease; PEG: Percutaneous endoscopic gastrostomy.

Table 3 Comparison of weight assessments for patients with motor neuron disease undergoing percutaneous endoscopic gastrostomy

Time points	n1	Body mass index (mean ± SD) kg/m2
Usual	20	26.6 ± 4.3
Diagnosis	23	25.3 ± 4.0
Assessment	25	23.8 ± 3.6
PEG insertion	25	22.5 ± 3.0
3 mo post-PEG	16	22.6 ± 2.2
6 mo post-PEG	13	22.5 ± 2.0
Death	16	21.2 ± 2.2
		Percentage of weight loss (mean ± SD)
Usual to diagnosis	22	5.8 ± 7.5
Diagnosis to assessment	26	5.9 ± 7.0
Assessment to PEG insertion	28	5.9 ± 5.9
PEG insertion to 3 mo after	18	-0.1 ± 6.02
3 to 6 mo post-PEG	13	1.4 ± 5.1
6 mo post-PEG to death	12	2.4 ± 4.9

¹Some data unavailable due to patients being unable to be weighed. Usual-pre-MND diagnosis; Diagnosis-at diagnosis of MND; Assessment-when dietetic service was involved pre-PEG insertion;

²Percentage of weight gain. MND: Motor neuron disease; PEG: Percutaneous endoscopic gastrostomy.