Can percutaneous endoscopic gastrostomy be carried out safely in the elderly?

Percutaneous endoscopic gastrostomy (PEG) is carried out commonly for patients with dysphagia. Clinicians, however, are often reluctant to carry out PEG in the elderly because of concerns about complications and short life expectancy. The present study aimed to assess the safety of PEG in elderly patients.

The medical records of 116 patients who received PEG from October 2005 to May 2012 were reviewed retrospectively. Among them, 63 patients were aged 65 years and older (the elderly group), and 53 were aged less than 65 years (the younger group).

Baseline characteristics showed no significant difference in both groups, except that pulmonary comorbidities was more common in the elderly group (P = 0.003). Overall, PEG-related complications occurred in 23 (19.8%) patients. Wound infections were the most common (15 patients), and followed by gastrointestinal bleeding, esophageal injury, pneumomediastinum and buried bumper syndrome. Although there was no difference in the overall complications, wound infections were less frequent in the elderly group than in the younger group (4 [6.3%] out of 63 vs 11 [20.8%] out of 53, P = 0.027). There were 17 (14.7%) cases of mortality, with three patients (2.5%) dying within 30 days after the procedure and the causes of deaths were unrelated to PEG. No significant difference in mortality rate was observed between the two groups (13 [20.6%] vs 4 [7.5%], P = 0.065).

PEG can be carried out safely in elderly patients, as procedure-related complications and mortality did not increase compared with those of younger patients.