To the Editor.

Strauss et al recently published a large retrospective population-based study on the effect of tubefeeding on mortality in children with severe disabilities and mental retardation. In their introduction they quoted our study on outcomes after endoscopic gastrostomy placement in 30 children with severe neurological impairment. Strauss et al wrote that “… although none of the children […] were preoperatively felt to have significant pulmonary disease, 6 of 30 children who underwent a percutaneous endoscopic gastrostomy tube placement died of chronic suppurative lung disease within 26 months of treatment.”

We are concerned that our study was not interpreted accurately and wish to clarify the issue. The 6 patients who died after percutaneous endoscopic gastrostomy (PEG) placement were at the severe end of the spectrum of neurological impairment. All had a past history of significant pulmonary disease with recurrent chest infections. This, in fact, prompted the need...

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