The Role of G-Tubes in Decreasing UTIs in a Cohort of Patients with Advanced MS

Background:

1) To show that the use of a specialized MS care model in patients who are homebound or in long-term care facilities (LTCF) can reduce morbidity

and mortality and improve quality of life (QOL). 2)To report on the incidence of urinary tract infections (UTIs) before and after a G-tube placement in a cohort

of severely disabled patients with MS living in a LTCF.

Objectives:

In an effort to provide comprehensive care of patients with MS in LTCF, the MS program at UNMC collaborated with a local facility to improve

quality of care outcomes. This involves the use of an MS-certified advanced registered nurse practitioner in the direct care of these patients.

In our experience, we found that disabled patients are often and more profoundly impacted by UTIs in LTCF. Severely disabled patients are at high risk for

dehydration which is a contributing factor to UTIs. Gastric tubes (G-Tubes) are a relatively low risk procedure that can be used to help supplement hydration.

We began incorporating this treatment in the management of these high-risk patients.

Methods:

This is an exploratory review of patients within a LTCF describing the incidence of UTIs 1 year before and 1 year after G-tube insertion for

hydration. In a semi-structured qualitative fashion this study will also explore the perception of quality-of-life measures of patient, family and staff members

after G-tube insertion for hydration. Inclusion criteria will be all MS patients in the LTCF with an EDSS scores of 8 or greater that had G-tube placement with

supplemental hydration. Currently there are at least 4 patients who meet criteria.

Results:

Thus far, 4 patients have been observed showing a reduction in UTIs and improvement of QOL. 

Conclusions:

Preliminary findings support a

beneficial role for G-tube in preventing UTIs, hospitalizations and ultimately cost of care.