[Usefulness and problems of percutaneous endoscopic gastrostomy in a geriatric hospital]

Usefulness and problems of percutaneous endoscopic gastrostomy (PEG) placement in a geriatric hospital where most patients were severely demented or bed-ridden were evaluated. The variables examined were acute complications, chronic complications, restraint of patients before and after PEG placement, change in physical activity, and ability of oral intake. Results showed that both acute and chronic complications were not rare, but these problems are not peculiar to geriatric hospitals. Quality of life (QOL) was clearly improved. Restraint could be reduced or stopped in 65.2% of restrained patients after PEG tube placement, activity was improved in 55.5% of patients, and oral intake became possible in 14.0% of patients. There were also some improvements in the management of PEG, as the incidence of self-extubation decreased, and tube exchange became easier. In conclusion, it is possible to insert and manage the PEG tubes even in geriatric hospitals, and PEG tubes are quite useful in managing patients with chronic disease and in improving QOL.