Complications and outcome of percutaneous endoscopic gastrostomy in a high-volume centre

Area of Science:

• Gastroenterology
• Clinical Medicine
• Surgical Procedures

Background:

• Percutaneous endoscopic gastrostomy (PEG) is standard for long-term enteral feeding in patients with swallowing difficulties and intact gastrointestinal function.
• Limited data exists on the demographics and clinical profiles of patients requiring PEG removal.

Purpose of the Study:

• To investigate the characteristics and outcomes of patients undergoing PEG placement and removal.
• To identify risk factors for complications and mortality in PEG patients.

Main Methods:

• Retrospective analysis of 495 adult patients who received their first PEG placement between August 2013 and December 2015.
• Data collected included patient demographics, diagnoses, complications, and reasons for PEG removal.

Main Results:

• The study included 495 patients (56% male, mean age 67 years). Neurologic (52%) and oncologic (32%) diagnoses were most common.
• Major complications occurred in 2.0% of patients. Increased age and low BMI were mortality risk factors but not associated with complication rates.
• PEG was removed in 33.3% of patients, primarily from the oncology group, often due to improved patient status after treatment.

Conclusions:

• Advanced age and low BMI are significant risk factors for mortality in PEG patients, independent of complication rates.
• Sulfamethoxazole and trimethoprim antibiotic prophylaxis appears effective in preventing complications in patients with PEG.
• PEG removal is common, particularly in oncology patients, indicating potential for recovery or treatment success.