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Underlying disease for percutaneous endoscopic gastrostomy tube placement predicts short- and long-term mortality
L Bochatay1,2, C Bastid1, J Robert1
1Department of Gastroenterology and Hepatology, University Hospital of Geneva, Switzerland.
Insights
Percutaneous endoscopic gastrostomy (PEG) placement has high mortality rates, especially in patients with certain underlying diseases. The study suggests PEG may serve as a temporary nutritional support method.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Patient Outcomes
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a common endoscopic procedure for enteral feeding.
- PEG is not beneficial for patients with limited life expectancy or certain progressive diseases.
- Assessing mortality rates post-PEG is crucial for patient selection and care.
Purpose of the Study:
- To evaluate short-term and long-term mortality rates following PEG tube placement.
- To identify factors influencing mortality after PEG procedures.
- To determine the role of PEG in different patient populations.
Main Methods:
- A retrospective study of 219 patients undergoing PEG placement between January 2011 and December 2014.
- Data collected included patient parameters and the primary indication for PEG.
- Patients were categorized into four groups based on their underlying disease.
Main Results:
- 33 patients (15.1%) died within 60 days, and 71 patients (32.4%) died within one year.
- The overall median survival was 870 days.
- Underlying disease was identified as the sole significant predictor of both short-term and long-term mortality in multivariate analysis.
Conclusions:
- PEG tube placement is associated with significant short- and long-term mortality, which is heavily influenced by the patient's underlying condition.
- PEG may be best utilized as a transient supportive measure for nutritional management.
- Careful patient selection based on underlying disease is essential for optimizing outcomes after PEG.
Background:
PEG (percutaneous endoscopic gastrostomy) is a well established endoscopic procedure for enteral feeding. However, patients with a shorter life expectancy will not benefit from PEG tube placement. Furthermore, some specific evolving diseases will never benefit from PEG. The aim of the study focuses on short and long term mortality rates after PEG tube placement in a referral gastroenterology centre (Geneva University Hospital). 219 patients were enrolled in this study.
Patients And Methods:
All patients scheduled for a PEG procedure between January 2011 and December 2014 were included. Nine patient parameters were collected for further analysis as well as the main underlying disease requiring PEG tube placement. Patients were subsequently divided into 4 groups according to underlying disease: Group 1) swallowing disorders of neurologic origin; Group 2) swallowing disorders associated with upper digestive tract neoplasia ; Group 3) nutritional support for a non GI reason ; Group 4) Other.
Results:
219 patients had undergone a PEG tube placement. 33 patients died within 60 days after the procedure. After one year, 71 patients died. Global survival was 870 days. The nutritional support group had the better survival rate with 1276 days compared to the swallowing groups and others. The multivariate analysis has highlighted the underlying disease as the only associated parameter with short and long term mortality.
Conclusions:
PEG tube placement is associated with high short and long term mortality depending on the underlying disease. We outlined the potential role of PEG tube insertion as a supportive transient approach for nutritional support.
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