To determine the number of older Western Australians who had a gastrostomy tube (GT) placement from 1994 to 2004, to describe their characteristics, and to examine outcomes after GT placement, including rehospitalisation for complications and survival.

Secondary analysis of hospital (inpatient) data and linked mortality data from the WA Data Linkage System.

Patient characteristics (age, sex and morbidity profile); numbers of GT closures, replacements and complications within 1 year of GT placement; age- and sex-specific survival outcomes calculated at 7, 30, 60 and 180 days, and 1 and 3 years; and mortality hazard ratios calculated for six conditions of interest, identified using all available diagnosis information on the inpatient record.

In Western Australia, 2023 people aged 65 years or older underwent a GT placement for the first time during the period 1994–2004, half of whom had a known history of cerebrovascular disease (50.3%). Rehospitalisation within 1 year for a GT replacement procedure, mechanical complications and incident pneumonitis occurred in 13%, 4% and 9% of patients, respectively. More than half of the patients who underwent a GT placement died within 1 year. Survival outcomes were poorest for patients with motor neurone disease and metastatic cancer.

To better understand this complex area of health care, questions regarding decision making — by patients, families, physicians, hospitals and other caring organisations — about GT placement and maintenance need to be addressed.