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Surgical Endoscopy

, Volume 27, Issue 10, pp 3806–3815 | Cite as

Risk factors for complications and mortality of percutaneous endoscopic gastrostomy: a multicenter, retrospective study

  • Changhyun Lee
  • Jong Pil Im
  • Ji Won Kim
  • Seong-Eun Kim
  • Dong Yup Ryu
  • Jae Myung Cha
  • Eun Young Kim
  • Eun Ran Kim
  • Dong Kyung Chang
  • Small Intestine Research Group of the Korean Association for the Study of Intestinal Disease (KASID)
Article

Abstract

Background

Percutaneous endoscopic gastrostomy (PEG) is performed to provide nutrition to patients with swallowing difficulties. A multicenter study was conducted to evaluate the predictors of complications and mortality after PEG placement.

Methods

This study retrospectively analyzed patients who underwent initial PEG placement between January 2004 and December 2011 at seven tertiary hospitals in the Republic of Korea.

Results

All 1,625 patients underwent PEG placement by the pull-string method. The median age of the patients was 66 years, and 1,108 of the patients were men. The median follow-up period was 254 days. The common indications were stroke (31.6 %) and malignancy (18.9 %). The complication rate was 13.2 %. The prophylactic use of antibiotics (odds ratio [OR], 0.58; 95 % confidence interval [CI], 0.38–0.88; p = 0.010) reduced the PEG-related infection rate, but the actual usage rate was 81.1 %. The use of anticoagulants (OR, 7.26; 95 % CI, 2.23–23.68; p = 0.001) and the presence of diabetes mellitus (OR, 4.02; 95 % CI, 1.49–10.87; p = 0.006) increased the risk of bleeding, but antiplatelet therapy did not. The procedural, 30-day, and overall mortality rates were 0.2, 2.4 and 14.0 %, respectively. Serum albumin levels lower than 31.5 g/L (OR, 8.55; 95 % CI, 3.11–23.45; p < 0.001) and C-reactive protein levels higher than 21.5 mg/L (OR, 3.01; 95 % CI, 1.27–7.16; p = 0.012) increased the risk of 30-day mortality, and the patients who had both risk factors had a significantly shorter median survival time than those who did not (1,740 vs 3,181 days) (p < 0.001, log-rank).

Conclusions

The findings showed PEG to be a safe and feasible procedure, but the patient’s nutritional and inflammatory status should be considered in predicting the outcomes of PEG placement.

Keywords

C-reactive protein Gastroscopy Mortality Percutaneous endoscopic gastrostomy Serum albumin 

Notes

Disclosures

Changhyun Lee, Jong Pil Im, Ji Won Kim, Seong-Eun Kim, Dong Yup Ryu, Jae Myung Cha, Eun Young Kim, Eun Ran Kim, and Dong Kyung Chang have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Changhyun Lee
    • 1
    • 2
  • Jong Pil Im
    • 3
  • Ji Won Kim
    • 4
  • Seong-Eun Kim
    • 5
  • Dong Yup Ryu
    • 6
  • Jae Myung Cha
    • 7
  • Eun Young Kim
    • 8
  • Eun Ran Kim
    • 9
  • Dong Kyung Chang
    • 9
  • Small Intestine Research Group of the Korean Association for the Study of Intestinal Disease (KASID)
  1. 1.Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam CenterSeoul National University HospitalSeoulRepublic of Korea
  2. 2.Liver Research Institute, Seoul National University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
  4. 4.Department of Internal MedicineSeoul National University Boramae HospitalSeoulRepublic of Korea
  5. 5.Department of Internal MedicineEwha Womans University Medical CenterSeoulRepublic of Korea
  6. 6.Department of Internal MedicinePusan National University HospitalPusanRepublic of Korea
  7. 7.Department of Internal MedicineKyung Hee University College of Medicine, Gang Dong Kyung Hee University HospitalSeoulRepublic of Korea
  8. 8.Department of Internal MedicineCatholic University of Daegu School of MedicineDaeguRepublic of Korea
  9. 9.Department of Internal MedicineSamsung Medical Center, Sungkyunkwan University School of MedicineSeoulRepublic of Korea

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