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Published on: May 26, 2023
Pneumonia and mortality after percutaneous endoscopic gastrostomy insertion
Neville Azzopardi1, Pierre Ellul
1Mater dei Hospital, Department of Gastroenterology, Tal Qroqq, Malta. oldcharm@onvol.net
Summary
Percutaneous endoscopic gastrostomy (PEG) feeding significantly reduces pneumonia risk compared to nasogastric tube feeding in patients with neurological dysphagia. However, pneumonia remains a primary cause of mortality following PEG insertion.
Area of Science:
- Gastroenterology
- Pulmonology
- Critical Care Medicine
Background:
- Percutaneous endoscopic gastrostomy (PEG) feeding is crucial for enteral nutrition in patients with neurological dysphagia.
- Reported 30-day mortality rates post-PEG range from 4-26%, with pneumonia being a frequent complication.
Purpose of the Study:
- To compare the incidence of pneumonia in patients fed via nasogastric tubes versus PEG tubes.
- To analyze indications, prognostic factors, and mortality associated with PEG insertion.
Main Methods:
- Retrospective analysis of PEG tube insertions in Malta from January 2008 to June 2010.
- Comparison of pneumonia incidence between nasogastric and PEG feeding groups.
- Analysis of mortality and prognostic factors for PEG insertion.
Main Results:
- PEG feeding showed a statistically significant reduction in pneumonia episodes compared to nasogastric feeding (p < 0.005).
- Pneumonia was the cause of death for 29 out of 47 deceased patients.
- 30-day mortality was 8%, with pneumonia being a major contributor to early deaths.
Conclusions:
- PEG feeding is associated with a lower incidence of pneumonia compared to nasogastric feeding.
- Despite the reduction, pneumonia remains the leading cause of mortality in PEG patients.
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