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Factors Associated With Short-Term Complications After Percutaneous Endoscopic Gastrostomy Tube Insertion: A
Mostafa Shehata1, Ibrahim Al Hosani1, Ishtiaq Ahmed1
1Gastroenterology, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, ARE.
Background:
Percutaneous endoscopic gastrostomy (PEG) tube placement is generally safe but is associated with a range of complications. Minor complications include infections, granuloma formation, leakage, and blockages, while major complications encompass aspiration pneumonia, hemorrhage, and more serious conditions such as necrotizing fasciitis and colonic fistula.
Aim:
This study aimed to assess the rate of short-term complications within one month of endoscopic PEG insertion, focusing on their correlation with patient characteristics.
Methodology:
This retrospective cohort study analyzed data from patients who underwent PEG insertion between January 2020 and December 2022. It evaluated the incidence of complications in relation to variables such as the indication for the procedure, the patient's immune status, albumin and CRP levels, and the setting of the procedure (inpatient vs. outpatient).
Results:
The study included 121 patients, with a mean age of 69.73 years, comprising 71 males (58.7%) and 50 females (41.3%). Neurological indications accounted for 64.5% of the cases. Notably, 67.8% of the patients were immunocompromised. Within 30 days of PEG insertion, 16.5% experienced complications, including GI bleeding (4.1%), infection at the PEG site (11.6%), and peritonitis (0.8%). Complications were significantly higher in immunocompromised patients and those with non-neurological indications. Higher serum albumin and lower CRP levels were associated with fewer complications, though the association was not statistically significant.
Conclusion:
The study highlights that gastrostomy site infection is the most common short-term complication following PEG insertion. Immune status and the reason for PEG insertion emerged as key factors influencing the likelihood of complications.
Insights
Short-term complications after percutaneous endoscopic gastrostomy (PEG) tube placement are common, particularly gastrostomy site infections. Immunocompromised patients and those with non-neurological indications face higher risks.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Patient Safety
Background:
- Percutaneous endoscopic gastrostomy (PEG) tube placement is a common procedure.
- While generally safe, PEG insertion is associated with various complications, ranging from minor infections to severe conditions.
Purpose of the Study:
- To evaluate the incidence of short-term complications within 30 days of endoscopic PEG insertion.
- To identify patient characteristics that correlate with these complications.
Main Methods:
- Retrospective cohort study of 121 patients undergoing PEG insertion (January 2020 - December 2022).
- Analysis of complication rates based on indication, immune status, albumin/CRP levels, and procedure setting.
- Evaluation of short-term outcomes including GI bleeding, site infection, and peritonitis.
Main Results:
- 16.5% of patients experienced complications within 30 days.
- Gastrostomy site infection (11.6%) was the most frequent complication.
- Complications were significantly higher in immunocompromised patients and those with non-neurological indications.
Conclusions:
- Gastrostomy site infection is the primary short-term complication post-PEG insertion.
- Patient immune status and the indication for PEG placement are critical factors influencing complication risk.
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