Risk factors for complications in infants and children with percutaneous endoscopic gastrostomy tubes

Area of Science:

• Pediatric Gastroenterology
• Surgical Outcomes
• Medical Device Safety

Background:

• Percutaneous endoscopic gastrostomy (PEG) tubes are frequently used in pediatric care for nutritional support.
• Complications following PEG tube placement can significantly impact patient recovery and healthcare resource utilization.
• Identifying risk factors is crucial for improving patient safety and management strategies.

Purpose of the Study:

• To determine the incidence and types of complications associated with PEG tube placement in pediatric patients.
• To identify patient-specific risk factors and protective factors for major and minor complications.

Main Methods:

• Retrospective chart review of 591 pediatric patients who underwent PEG tube placement between 2006 and 2010.
• Analysis of complication data, including frequency, type, and timing (major vs. minor).
• Univariate and multivariate statistical analyses to identify risk factors for PEG tube complications.

Main Results:

• 198 PEG-related complications (72 major, 126 minor) were observed in 591 patients.
• Major complications occurred in 10.5% and minor complications in 16.4% of patients, often post-discharge.
• Younger age (<6 months), ASA class III, and neurologic disorders were protective against major complications; ventriculoperitoneal shunts were a risk factor.

Conclusions:

• Minor and major complications are frequent after pediatric PEG tube placement, with a significant proportion occurring months post-procedure.
• Specific patient characteristics, such as younger age and certain comorbidities, may influence complication risk.
• The presence of a ventriculoperitoneal shunt is associated with an increased risk of major complications following PEG tube placement.