Percutaneous endoscopic gastrostomy: a community hospital experience

Percutaneous endoscopic gastrostomy (PEG) is a well established procedure for establishing a feeding port in patients unable to take oral nutrition. As these patients are often elderly with multiple ailments, mortality due to comorbidities is common. This retrospective study reviewed the experience with PEG in a community hospital, with particular attention paid to morbidity and mortality rates. Randomly selected charts of 100 patients who had PEG performed at our hospital between 1987 and 1991 were examined. These records were reviewed for patients' age, gender, indications, intraoperative complications, and final disposition. Procedure-related morbidity was defined as any untoward event or death that could not be directly attributed to the patient's primary disease process. The sample consisted of 33 males and 67 females whose ages ranged from 47 to 102 years, with a mean of 82 years. The most common indications were malnutrition (n = 48) and dysphagia due to neurological problems (n = 38). The only procedure-related intraoperative complication involved a patient with uncomplicated umbilical hernia who developed strangulation. The morbidity rate was 4% and the 30-day mortality rate was 16%. Only one death was directly related to the PEG tube, and a second death was possibly related to the PEG tube. This community hospital's experience with PEG reveals low morbidity and mortality rates compared to Stamm gastrostomy. These results confirm that PEG is the procedure of choice for providing aging patients with a safe route for enteral nutrition.