Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy

JSLS. 2021 Jul-Sep;25(3):e2021.00040. doi: 10.4293/JSLS.2021.00040.

Abstract

Introduction: Percutaneous endoscopic gastrostomy (PEG) is the main accepted method for long-term tube feeding. The aim of this study is to investigate the risk factors associated with early mortality after PEG.

Methods: It is a retrospective survival analysis in a tertiary-level hospital. We reviewed the medical records of 277 patients with PEG placement. The data were analyzed by the Kaplan-Meier method. Multivariable Cox proportional regression models were also built to test the effects of PEG on mortality.

Results: A total of 277 patients who submitted to PEG were studied. One-hundred and sixty (58%) were female, mean age of 73.3 ± 15.7 years. Ninety-three patients (33.6%) had diabetes mellitus and 165 (59.6%) had blood hypertension. The indications for PEG placement were chronic neurologic dysphagia in 247 (89.5%) patients and tumors and other diseases in 29 (10.5%). The 30 days proportional mortality probability rate was 13%. In a multivariate Cox proportional regression model, preoperative ICU hospitalization (HR 1.79, 95% CI 1.36-2.36, P = 0.000) and hemoglobin (HR 0.91, 95% CI 0.85-0.98, P = 0.015) were predictors of early mortality.

Conclusion: In patients who had underwent PEG tube insertion for long-term nutrition, anemia and previous ICU admission were predictors of mortality at four weeks. These factors may guide physicians to discourage the indication for PEG.

Keywords: Critical illness; Deglutition disorders; Enteral nutrition; Malnutrition; PEG tube.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Deglutition Disorders*
  • Enteral Nutrition
  • Female
  • Gastrostomy*
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Risk Factors