MS Patients Needing Feeding Tubes May Live Longer if Given Before Age 50, Study Finds

A total of 53 patients (37 women and 16 men), with a mean age of 55.4, were identified. Most had secondary progressive MS (86.8%), with a mean 17.8 years since their disease was diagnosed, and were either using wheelchairs (52.8%) or were confined to a bed (41.5%).

Gastrostomy tubes were placed mostly due to swallowing difficulties (54.7%), and aspiration pneumonia or recurrent pneumonia (26.4%). Slightly more than half of  these patients (52.8%) were discharged to their homes from a hospital, while others (47.2%) went to a nursing home.

Records showed a median hospital stay of 14 days after the procedure, and a median survival of nearly two years (21.73 months).

A clear majority (81.1%; 43 people) were alive one year after the procedure, and more than half (54.7%; 29 people) at two years. Eleven lived for five years after tube placement (22.4%), and three were alive at 10 years (6.8%).

Those who had a feeding tube placed before their 50s survived significantly longer (median of 28.48 months; more than two years), compared with patients undergoing the procedure at later ages (median of 17.51 months; nearly a year and a half), data showed.

Age (younger or older than 50) was the sole predictor of better survival with this procedure, the study reported. No other parameter — including type and duration of MS, disability level, mobility, gender, elective or emergency surgery, and place of residence after hospital discharge from hospital — was seen to predict survival.

“In these [previous] studies the cut-off age for poor survival after gastrostomy for neurogenic dysphagia was 75 years,” the researchers wrote. “Our data found that the cut-off age for poor survival in patients with MS was 50 years. This could be because, unlike other neurodegenerative conditions causing dysphagia, MS is predominately a disease of young working-age adults.”

They also reported that while use of a feeding tube “is likely to extend the survival of people with dysphagia due to MS” by better meeting their nutritional needs, “it may not prevent aspiration pneumonia.”

The most frequent cause of death in this patient group was respiratory tract infection (45.3%, 24 of 53 people), followed by MS or frailty (26.4%; 14 patients). Findings of death due to respiratory tract infections are consistent with data from a previous study on survival after feeding tube placement in people with dysphagia due to a neurologic disease.