# 084 Swallow Studies, Tube Feeding and the Death Spiral, 2nd ed

Introduction:   The reflex by families and doctors to provide nutrition for the patient who cannot swallow is overwhelming. It is now common practice for such patients to undergo a swallowing evaluation and if there is significant impairment to move forward with feeding tube placement (either nasogastric or gastrostomy) – see Fast Fact #128. Data suggest that in-hospital mortality for hospitalizations in which a feeding tube is places is 15-25%, and one year mortality after feeding tube placement is 60%. Predictors of early mortality include: advanced age, CNS pathology (stroke, dementia), cancer (except early stage head/neck cancer), disorientation, and low serum albumin.