Complications after percutaneous endoscopic gastrostomy in a prospective study

Area of Science:

• Gastroenterology
• Clinical Medicine
• Surgical Procedures

Background:

• Percutaneous endoscopic gastrostomy (PEG) is a common procedure for patients with nutritional needs and dysphagia.
• Understanding PEG complication rates is crucial for informed clinical decision-making.

Purpose of the Study:

• To prospectively evaluate the rates of specific complications and mortality within two months following PEG insertion.
• To assess early outcomes in an unselected patient cohort undergoing PEG.

Main Methods:

• A prospective study included 484 patients undergoing PEG insertion.
• Kaplan-Meier curves estimated 60-day mortality; Fisher's exact test compared proportions.
• Six pre-defined complications (leakage, diarrhea, constipation, abdominal pain, fever, peristomal infection) were tracked.

Main Results:

• 18% (85/484) of patients died within two months post-PEG.
• Early mortality risk was significantly higher in patients with neurological disease compared to those with tumors (p < 0.001).
• Excluding mortality, 2-week and 2-month complication rates were 39% and 27%, respectively. Common early complications included abdominal pain, peristomal infection, diarrhea, and leakage.

Conclusions:

• PEG insertion presents a substantial short-term risk of complications and mortality.
• These risks necessitate careful consideration in clinical decision-making and patient/caregiver counseling.