Complications and outcome of percutaneous endoscopic gastrostomy in a high-volume centre

Scand J Gastroenterol. 2019 Apr;54(4):513-518. doi: 10.1080/00365521.2019.1594354. Epub 2019 Mar 24.

Abstract

Introduction: Percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term enteral feeding for patients with swallowing disorders and normal gut function. There is limited data regarding the demographics and clinical characteristics of patients from whom PEG was removed. Patients and methods: We performed a retrospective analysis of all consecutive adult patients who underwent first placement of PEG between 1 August 2013 and 31 December 2015 at Karolinska University Hospital in Stockholm, Sweden. Results: In total, 495 PEG were inserted in 495 patients during the study period, 56% male, mean age at insertion 67 years (range 19-95). Most patients belonged to the neurologic group (52%), followed by the oncologic (32%), another diagnosis (9%) and trauma (7%). Major complications occurred in 10 (2.0%) patients. There were no differences in the age or BMI of patients with either minor or major complications but both parameters were risk factors in terms of survival. PEG was removed from 165 (33.3%) patients, most of them from the oncology group, due to the improvement of general status of patients after specific oncologic treatment. Conclusion: Increased age and low BMI were identified as risk factors for mortality but did not correspond with the rate of complications. Antibiotic prophylaxis with sulfamethoxazole and trimethoprim provides good protection for patients with PEG.

Keywords: Percutaneous; complications; endoscopic; gastrostomy; outcome.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antibiotic Prophylaxis
  • Body Mass Index
  • Deglutition Disorders / etiology
  • Deglutition Disorders / therapy*
  • Endoscopy*
  • Enteral Nutrition / mortality
  • Female
  • Gastrostomy / adverse effects*
  • Gastrostomy / mortality
  • Hospitals, High-Volume*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Nervous System Diseases / complications
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Sweden / epidemiology
  • Time Factors
  • Wounds and Injuries / complications
  • Young Adult