Percutaneous endoscopic gastrostomy feeding effects in patients with neurogenic dysphagia and recurrent pneumonia

Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) feeding provides enteral nutrition to patients with neurological dysphagia. However, the conditions in which PEG should be applied to prevent pneumonia remain unclear. We aimed to evaluate the effect of PEG for patients with neurological dysphagia in preventing pneumonia. Methods: We undertook a retrospective data review of 232 patients with neurological dysphagia who had undergone PEG from January 2008 to December 2018 at Inha University Hospital, in Incheon, Korea. We excluded patients who had not been followed up 6 months pre- and post-PEG feeding. In total, our study comprised 42 patients. We compared pneumonia episodes and incidence pre- and post-PEG. Results: During the median post-PEG follow-up period, the 6-month pneumonia incidence among patients who had undergone PEG had decreased [median 0.3 (interquartile range (IQR) 0.0–0.7) versus 0.1 (IQR 0.1–0.3) episodes, p = 0.04]. In a multiple mixed model, PEG did not decrease the incidence of pneumonia ( p = 0.76). However, the association between PEG and the incidence of pneumonia differed significantly depending on the presence or absence of recurrent pneumonia ( p < 0.001). Conclusions: PEG could effectively reduce the incidence of pneumonia in patients with neurogenic dysphagia, especially in those who had experienced recurrent pneumonia. The reviews of this paper are available via the supplemental material section.

Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease

“…Percutaneous endoscopic gastrostomy (PEG) insertion must be considered whenever oral feeding becomes insufficient for well tolerated and effective intake of food and fluids, resulting in significant weight loss and/or dehydration [75 ▪ ,116]. PEG may decrease the risk of pneumonia in patients with neurogenic dysphagia, especially in those who had experienced recurrent pneumonia [116], and improve the patients’ quality of life [117].…”