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Safety of Percutaneous Endoscopic Gastrostomy Tubes in Centenarian Patients
Zain A Sobani1, Kevin Tin2, Steven Guttmann3,4
1Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
Insights
Percutaneous endoscopic gastrostomy (PEG) tube placement is safe for patients over 100 years old. While minor complication rates are higher, success rates and mortality are comparable to younger patients.
Area of Science:
- Geriatric Medicine
- Gastroenterology
- Endoscopic Procedures
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a common procedure.
- Safety data for PEG placement in centenarians is lacking.
Purpose of the Study:
- To evaluate the safety and efficacy of PEG tube placement in patients aged 100 years and older.
- To compare outcomes in centenarians versus a younger patient cohort.
Main Methods:
- Retrospective review of patient records.
- Identified 30 patients aged 100+ years and compared them to a random sample of 275 younger patients.
Main Results:
- No significant difference in procedural success rates or inpatient mortality between centenarians and younger patients.
- Centenarians had a higher rate of minor complications (13.3% vs. 2.9%).
- Centenarian group was predominantly female (80%).
Conclusions:
- PEG tube placement is a viable option for carefully selected centenarian patients.
- Outcomes are comparable to younger patients, with the exception of a higher minor complication rate.
- Further research may focus on mitigating minor complications in this age group.
Background/Aims:
Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure; however, no study has evaluated the safety of PEG tube placement in patients over the age of 100 years.
Methods:
We conducted a retrospective review of patient records for patients who underwent PEG tube placement. Thirty patients aged 100 years and older were identified and a random sample of 275 patients was selected for comparison.
Results:
The mean age of the patients was 80.6±16.2 years. No procedure-related deaths or major complications were identified; the overall inpatient mortality rate was 7.6%. Minor complications were noted in 4% (n=12) of the patients. Centenarian patients were predominantly female (80% [n=24] vs. 54% [n=147], p=0.006), with a mean age of 100.5±0.9 years. There was no significant difference in procedural success rates (93.3% vs. 97.4%, p=0.222) or inpatient mortality (6.7% [n=2] vs. 7.7% [n=21], p=1.000) between the two groups. However, a higher minor complication rate was noted in the older patients (13.3% [n=4] vs. 2.9% [n=8], p=0.022).
Conclusions:
Success rates, major complications and inpatient mortality associated with PEG tubes in patients aged over 100 years are comparable to those observed in relatively younger patients at our center; however minor complication rates are relatively higher. These findings lead us to believe that PEG tubes may be safely attempted in carefully selected patients in this subset of the population.
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