Long‐term prognosis and satisfaction after percutaneous endoscopic gastrostomy in a general hospital*

Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) has been widely acknowledged as a safer method for enteral feeding; however, its long-term impact on prognosis and quality of life in elderly patients is not sufficiently understood. There are issues still to be studied regarding the indications for PEG, due to the lack of convincing evidence that it reduces expected complications such as aspiration pneumonia or for improving the prognosis of patients with severe dementia. Method:In this study we investigated the survival rate after PEG and the families' satisfaction in 78 inpatients who underwent PEG. We conducted the investigation by sending questionnaires to the families. Results:The results for the 69 cases (88%) in which the patient recovered showed that the 1-year survival rate was 64.0%, and the 2-year survival rate was 55.5%. Fifty-three per cent of patients' families indicated overall satisfaction regarding of PEG. Conclusions:The survival rates were relatively higher than those from previously reported studies. This may be attributed to variations in patients' clinical, socio-economic, or cultural backgrounds in therapeutic interventions. We recognized the importance of clarifying factors that would affect the living and functional prognosis and quality of life in elderly patients who underwent PEG. The indications for PEG are based on a comprehensive assessment of the relevant factors in individual cases, and by taking patients' and families' wishes into consideration.

Survival period after tube feeding in bedridden older patients

“…Rejecting tube feeding in approximately 90% of the families caring for these terminal patients might decrease tube feeding by half 3 . Onishi et al 18 . reported that approximately half of families were satisfied with gastrostomy tube feeding.…”

“…17 Rejecting tube feeding in approximately 90% of the families caring for these terminal patients might decrease tube feeding by half. 3 Onishi et al 18 reported that approximately half of families were satisfied with gastrostomy tube feeding. The quality of informed consent for placement of the gastrostomy tube was inadequate in a large community-teaching hospital.…”

Low Serum Albumin Level is Risk Factor for Patients with Percutaneous Endoscopic Gastrostomy

“…In addition, low lymphocyte count was a risk factor for patients treated with PEG for malignant diseases. Previous studies did not evaluate long-term survival, but have indicated that the prognosis of PEG is influenced by several factors, including aging, sex, dementia, low serum albumin level, low serum cholesterol level, hyponatremia, and severe comorbidity including complicated pneumonia, cardiovascular diseases, and malignant diseases (2)(3)(4)(6)(7)(8)(9)(10)(11)(12). Judging from the one-year follow-up in the present study, nutritional status, as reflected by serum albumin level, might be crucial for survival after PEG, although rapid turnover proteins and other markers of nutritional status were not evaluated in the present retrospective study.…”

Long‐term outcome after placement of a percutaneous endoscopic gastrostomy tube

“…Although placement of a PEG tube is aimed for long‐term rather than short‐term enteral nutrition in most cases, the prognosis varies considerably between cases. Many factors seem to be associated with a long‐term prognosis complicatedly, but few studies have evaluated long‐term outcomes and prognostic factors related to PEG in Japan 3,4 . Therefore, we investigated long‐term survival and prognostic factors in patients who underwent this procedure.…”

“…Many factors seem to be associated with a long-term prognosis complicatedly, but few studies have evaluated long-term outcomes and prognostic factors related to PEG in Japan. 3,4 Therefore, we investigated long-term survival and prognostic factors in patients who underwent this procedure.…”