2nd World Congress on

Future of Aging & Rejuvenation Science

THEME: "Redefining Aging: Science, Innovation, and Longevity"

img2 20-21 Jul 2026
img2 Vienna, Austria
Jennifer Hanners Gutierrez

Jennifer Hanners Gutierrez

Texas Tech University Health Sciences Center School of Medicine, USA

Title: The relationship of feeding route (oral versus tube) to patient outcomes amid dysphagia and critical illness

Biography

Jennifer Hanners Gutierrez completed her Ph.D. at the Texas Tech University Health Sciences Center (TTUHSC) in 2019. Gutierrez is currently a medical speech-language pathologist at University Medical Center in Lubbock, Texas and serves as a Clinical Assistant Professor for the TTUHSC School of Medicine. In 2016, Gutierrez was the keynote speaker for the Nutrition in Palliative Care Symposium (China, Hong Kong). Gutierrez taught on oral feeding amid critical illness and dysphagia in Lucknow, India (2018-2020). Gutierrez led international training on least risk oral feeding amid life-limiting illness (2019) and conducts associated research, publishing seminal work in 2024.

Abstract

Background: Dysphagia is common in patients with life-limiting illness, yet nutritional decisions at the end of life often default to tube feeding under the assumption that it offers superior protection against aspiration and related complications. Existing evidence does not support this practice. This is the first prospective study to examine the impact of feeding route on clinical outcomes across diverse terminal diagnoses. This pilot study was designed to address the gap in research by prospectively evaluating whether oral versus tube feeding influences pneumonia, depression, or mortality in hospitalized adults who desired nutrition and had dysphagia.

Objective: To determine whether feeding route (oral vs. tube) is associated with pneumonia, depression, and mortality among patients with dysphagia and serious or terminal illness.

Methods: Sixty-five adults admitted to a tertiary care center between 2020 and 2024 were prospectively enrolled. All participants had dysphagia, a life-limiting diagnosis, and chose a feeding route through informed autonomous consent. Outcomes included pneumonia, depression, and mortality. Logistic regression analyses evaluated the association between feeding route and each outcome, first unadjusted and then adjusted for age and mortality risk. A propensity score matching analysis (n=30; 15 oral, 15 tube) further assessed associations within balanced groups.

Results: Tube feeding was strongly associated with higher rates of pneumonia and depression.

  • Pneumonia: 79% in tube-fed vs. 12% in oral-fed participants (p<0.001).
  • Unadjusted OR = 27.36 (95% CI: 7.68–119.81; p<0.01)
  • Adjusted OR = 19.28 (95% CI: 4.5–109.6; p<0.01)
  • Depression: 50% in tube-fed vs. 9.8% in oral-fed participants (p<0.001).
  • Unadjusted OR = 9.25 (95% CI: 2.68–38.36; p<0.01)
  • Adjusted OR = 17.25 (95% CI: 3.13–158.78; p<0.01)
  • Mortality: 46% in tube-fed vs. 17% in oral-fed participants (p=0.012).
  • Unadjusted OR = 4.11 (95% CI: 1.34–13.47; p=0.015) 
  • Adjusted OR = 2.78 (95% CI: 0.71–11.7; p=0.147)
    A composite outcome (pneumonia, depression, or mortality) occurred in 96% of tube-fed vs. 37% of oral-fed participants (p<0.001). 
  • Unadjusted OR = 39.87 (95% CI: 7.26–749.47; p<0.01) 
  • Adjusted OR = 55.64 (95% CI: 7.59–1235.15; p<0.01)

Propensity-matched findings mirrored the primary analysis: tube-fed patients had significantly higher rates of pneumonia (73% vs. 13%, p<0.001) and depression (47% vs. 6.7%, p=0.035), with mortality trending higher (40% vs. 27%, p=0.400).


Conclusions: Across both analytic approaches, tube feeding was consistently associated with significantly increased odds of pneumonia and depression, and with robustly elevated odds of experiencing at least one adverse outcome. Mortality trended higher with tube feeding, though not significantly after adjustment. These findings challenge the assumption that tube feeding is safer for patients with dysphagia at the end of life and support a more individualized, evidence-informed approach to nutritional decision-making that prioritizes patient autonomy, psychosocial wellbeing, and realistic assessment of risks. Larger multi-site studies are warranted to confirm these results and guide practice standards in palliative care.