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Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy

Diego L Lima1, Luiz Eduardo C Miranda2, Marcel Rolland Ciro da Penha2

  • 1Department of Surgery, Montefiore Medical Center, The Bronx, New York, USA.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 30, 2021
PubMed

Insights

Anemia and prior intensive care unit (ICU) admission are key risk factors for early mortality following percutaneous endoscopic gastrostomy (PEG) tube placement. Identifying these predictors can help clinicians optimize patient selection for long-term tube feeding.

Area of Science:

  • Gastroenterology
  • Critical Care Medicine
  • Geriatrics

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a standard procedure for long-term enteral nutrition.
  • Early mortality after PEG placement is a significant concern in vulnerable patient populations.

Purpose of the Study:

  • To identify risk factors associated with early mortality within 30 days of PEG insertion.
  • To evaluate the impact of preoperative conditions on post-PEG outcomes.

Main Methods:

  • Retrospective survival analysis of 277 patients undergoing PEG placement.
  • Kaplan-Meier survival analysis and multivariable Cox proportional regression models were employed.
  • Medical records were reviewed to extract relevant patient data and outcomes.

Main Results:

  • The 30-day mortality rate following PEG was 13%.
  • Preoperative intensive care unit (ICU) hospitalization was a significant predictor of early mortality (HR 1.79).
  • Lower hemoglobin levels (anemia) were also associated with increased early mortality risk (HR 0.91).

Conclusions:

  • Anemia and previous ICU admission are significant predictors of mortality within four weeks of PEG tube insertion.
  • These findings suggest that physicians should carefully consider these risk factors when deciding on PEG indications.
  • Optimizing preoperative hemoglobin levels and reassessing the need for PEG in patients with prior ICU stays may improve outcomes.
Abstract

Keywords:
Critical illnessDeglutition disordersEnteral nutritionMalnutritionPEG tube

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