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Longitudinal complications associated with PEG: Rate and severity of 30-day and 1-year complications experienced by
Conor Boylan1, Diane Barrett2, Vincent Li2
1University of Birmingham, College of Medical and Dental Sciences, United Kingdom.
Insights
Percutaneous endoscopic gastrostomy (PEG) complications occur in one-third of patients within a year, with most managed outpatient. Dysphagia patients experience fewer complications than head and neck cancer patients.
Area of Science:
- Gastroenterology
- Surgical Complications
- Patient Outcomes
Background:
- Percutaneous endoscopic gastrostomy (PEG) feeding is crucial for patients with poor oral intake.
- PEG insertion is associated with significant short- and long-term complications.
- Understanding these complications is vital for patient care and support.
Purpose of the Study:
- To review longitudinal complications associated with PEG feeding.
- To compare complication rates and characteristics between key patient subgroups.
- To inform support services and patient counseling regarding PEG insertion.
Main Methods:
- A single-center retrospective observational study was conducted.
- Data were collected from patients undergoing PEG insertion between January 2016 and December 2018.
- 306 patients met the inclusion criteria for analysis.
Main Results:
- 16.7% of patients experienced complications within 30 days, most commonly peristomal pain (9.2%).
- Within one year, 35.6% had at least one complication, with pain being most frequent (14.4%).
- Dysphagia patients had fewer complications and slower complication development compared to head and neck cancer patients.
Conclusions:
- Approximately one-third of patients experience PEG-related complications within a year.
- The majority of PEG complications can be managed in an outpatient setting.
- Findings highlight the need for improved patient counseling and support service planning.
Background And Aims:
Percutaneous Endoscopic Gastrostomy (PEG) feeding is utilised in patients with exceptionally poor oral intake but is associated with both short and long-term complications. This study reviews longitudinal PEG complications and compares key subgroups.
Methods:
Single-centre retrospective observational study of all patients receiving PEG insertion between January 2016 and December 2018.
Results:
306 patients met the inclusion criteria. The mean age at insertion was 67 years. The majority were cared for in their own home (80.4%) by themselves or family (74.9%). 127 PEG tubes were inserted for dysphagia and 165 prophylactically prior to treatment for head and neck cancer. In the first 30 days 16.7% experienced a complication. The most frequently reported was peristomal pain (9.2%). In the first year, 35.6% experienced at least one complication, 12.4% two complications and 6.6% three complications and 6.5% required inpatient treatment for their complication. The most common was pain (14.4%) followed by site weeping, site infection and external overgranulation. Patients with dysphagia took longer to develop complications, had fewer complications and took longer to require management by members of the secondary care team than those with head and neck cancer. Discounting peristomal pain, there was no difference in total complications between patients caring for themselves when compared to those receiving professional input.
Conclusion:
One third of patients will experience a complication related to their PEG tube over 1 year, but the majority are managed in an outpatient setting. This study has implications for planning support services and consenting and counselling patients pre-PEG-insertion.
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