To the Editor. —An editorial1 and an article2 appearing in the September 1989 issue of the Archives discussed the use of nasogastric feeding tubes in chronically ill, elderly patients. Quill's study2 shows that biomedical concerns, rather than quality-of-life issues, lead to the initiation of nasogastric tube feedings in most cases. We would like to report our experience with consultations for percutaneous endoscopic gastrostomy in chronically ill, elderly patients at the Dallas (Tex) Veterans Administration Medical Center.
We have retrospectively reviewed all the requests for percutaneous endoscopic gastrostomy over a 3-month period from October 1 through December 31, 1989. We received a total of 14 consults for placement of a percutaneous endoscopic gastrostomy tube (seven consults from the neurology service, six from general medicine, and one from general surgery). The patients were all male veterans, and had a mean age of 71 years. The principle diagnoses of these