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Percutaneous endoscopic gastrostomy and early mortality.
W K Clarkston1, O J Smith, J M Walden
1Department of Gastroenterology, University of Missouri, Kansas City School of Medicine.
Southern Medical Journal
|December 1, 1990
Summary
Percutaneous endoscopic gastrostomy (PEG) is associated with high early mortality, especially in cancer patients. A 60-day trial of nasogastric feeding may reduce unnecessary PEG procedures.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Patient Management
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a common procedure for nutritional support.
- Assessing the risks and benefits of PEG is crucial for patient care.
Purpose of the Study:
- To evaluate the morbidity, mortality, and long-term benefit of PEG.
- To identify patient groups with different outcomes after PEG.
Main Methods:
- Retrospective study of 42 patients who underwent PEG placement.
- Analysis of patient data including mortality, morbidity, and tube removal reasons.
Main Results:
- High mortality (43%) within 60 days post-PEG, stabilizing thereafter.
- Nearly half of PEG tubes (20/42) were removed within 60 days due to death or improvement.
- Patients with malignancy experienced significantly higher morbidity and 60-day mortality compared to neurologically impaired patients.
Conclusions:
- Careful patient selection for PEG is essential due to high early mortality.
- A 60-day trial of nasogastric feeding before PEG could halve the number of patients not benefiting long-term.
- Malignancy patients face greater risks and may not gain similar advantages from PEG.