Related Experiment Videos

Risk factors for mortality in patients undergoing percutaneous endoscopic gastrostomy

A Lang1, E Bardan, Y Chowers

  • 1The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, University of Tel-Aviv, Ramat-Gan, Israel. langa@sheba.health.gov.il

Endoscopy
|June 18, 2004
PubMed

Insights

Hospitalized patients face higher early mortality risks after percutaneous endoscopic gastrostomy (PEG) tube insertion compared to nursing home residents. Key risk factors include low albumin, COPD, and diabetes, significantly increasing 30-day mortality.

Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Geriatric Medicine

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a vital feeding method for patients unable to eat.
  • High early mortality rates have been observed in hospitalized patients undergoing PEG procedures.
  • Identifying risk factors for early mortality post-PEG is crucial for patient management.

Purpose of the Study:

  • To investigate and identify risk factors associated with early mortality following percutaneous endoscopic gastrostomy (PEG) tube insertion.
  • To compare mortality rates between hospitalized patients and nursing home outpatients after PEG.

Main Methods:

  • A comparative study analyzing data from 502 PEG insertions between July 1995 and July 2001.
  • Survival analysis was employed to evaluate mortality post-PEG.
  • Logistic regression identified predictors of 30-day mortality in hospitalized patients, including demographics, comorbidities, and PEG indications.

Main Results:

  • Hospitalized patients exhibited significantly higher 30-day (8% vs. 1.2%) and 60-day (12% vs. 2.4%) mortality rates compared to nursing home patients.
  • Low serum albumin (< 3 g/dl), chronic obstructive pulmonary disease (COPD), and diabetes mellitus were identified as independent risk factors for 30-day mortality in hospitalized patients.
  • These risk factors increased 30-day mortality threefold in the hospitalized group.

Conclusions:

  • Hospitalized patients undergoing PEG have a substantially elevated risk of early mortality compared to nursing home residents.
  • Diabetes, COPD, and hypoalbuminemia are significant predictors of increased 30-day mortality post-PEG in hospitalized individuals.
  • These findings underscore the need for careful patient selection and risk stratification prior to PEG insertion in hospitalized populations.
Abstract

Related Concept Videos

Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding01:15

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations: