Prediction of risk of adverse events related to percutaneous endoscopic gastrostomy: a retrospective study

Shangab, Maha Osman Mohamed; Shaikh, Niaz Ahmed

doi:10.20524/aog.2019.0409

Cited by 11 publications

(18 citation statements)

References 30 publications

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“…The most common complications examined in the current study included tube leakage, tube dislodgement, and wound infection, which is in line with findings from the literature (7)(8)(9)(10)(11)(12). The most frequently reported complications in the literature included leakage (up to 78%), peristomal infection (up to 32%), and early mortality (8%-28% mortality within 30 days of PEG insertion) (9).…”

Section: Resultssupporting

confidence: 84%

“…As with other studies in the literature, neurological diseases were the most common reason that PEG was recommended (2,4,11). In as many as 90% of cases, a reduction in oral intake due to neurodegenerative processes is the primary reason that patients undergo PEG placement (7)(8)(9)(10)(11). One interesting finding from this study was that dementia -which is a controversial indication for PEG tube placement -was the major indication for PEG placement (59%).…”

Section: Resultssupporting

confidence: 64%

Section: Resultsmentioning

confidence: 67%

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Predictive factors of complications and 30-day mortality in patients undergoing percutaneous endoscopic gastrostomy: the utility of C-reactive protein to albumin ratio

Düzenli¹,

Ketenci²,

Akyol³

et al. 2021

AGEB

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Background and study aims: Percutaneous endoscopic gastrostomy (PEG) is a procedure that provides long term enteral nutrition. To investigate the predictors of PEG-related complications and 30-day mortality rates and evaluate the indicators for deciding whether to recommend elective PEG insertions, we sought to determine the complications and early mortality rates of patients who underwent PEG. Patients and methods: We performed a retrospective analysis of consecutive adult patients who had undergone PEG for the first time between October 2016 and January 2019. The predictors of complications and 30-day mortality were analyzed with receiver operating characteristic (ROC) and logistic regression analysis. Results: This study included 309 patients. Patients were excluded from the study if they were < 18 years of age or there were missing data about them. Out of 253 patients, 33 (13%) had complications and 32 (12.6%) died within one month after PEG insertion. A higher C-reactive protein (CRP) to albumin ratio was the only independent factor predicting the complications (odds ratio (OR) : 3.17 ; 95% CI : 1.26-8.00 ; p = 0.014). The independent predictive factors for 30-day mortality after PEG placement included higher urea levels and higher CRP to albumin ratios (OR : 3.78 ; 95% CI : 1.41-10.17 ; p = 0.008) (OR : 6.67 ; 95% CI : 1.87- 23.75 ; p = 0.003). The only predictor for both complications and 30-day mortality was the CRP to albumin ratio. Conclusions: When appropriate, the PEG procedure can provide a safe and effective method for enteral feeding. The CRP to albumin ratio can be used to predict complications and early mortality after PEG insertion. Because PEG is elective, higher CRP to albumin ratios can be helpful in deciding to select patients for the procedure.

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Section: Resultssupporting

confidence: 84%

Section: Resultssupporting

confidence: 64%

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Predictive factors of complications and 30-day mortality in patients undergoing percutaneous endoscopic gastrostomy: the utility of C-reactive protein to albumin ratio

Düzenli¹,

Ketenci²,

Akyol³

et al. 2021

AGEB

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“…PEG is cost-effective, minimally invasive method of establishing prolonged enteral feeding (> 4 weeks), hydration, and medication administration for patients unable to sustain oral intake. 25,26 Adequate appropriate enteral nutrition can benefit critically ill patients by reducing complication rate and hospital stay. 27 The most common indication for PEG tube placement is dysphagia secondary to cerebrovascular accident (CVA), 28 but in the present study, road traffic accident was the most common indication followed by carcinoma esophagus and CVA.…”

Section: Discussionmentioning

confidence: 99%

“…24 The most common post-PEG complication reported is inadvertent PEG tube removal or dislodgement due to pliability of inner bolster. 25 We suggest boxing hand wrap/use of abdominal binder for elderly patients and DIN to prevent tube dislodgement. 33 BBS is an unusual complication with an estimated incidence ranging from 0.3 to 2.4%.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy-Assisted Percutaneous Endoscopic Gastrostomy (F-PEG)—Single-Center Experience and Outcome

Balekuduru

Bongu

Mandalapu

et al. 2020

Journal of Digestive Endoscopy

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Background Gastrointestinal route is considered for feeding in subjects who are unable to swallow, either as a temporary or permanent option. Percutaneous endoscopic gastrostomy (PEG) is the preferred mode for long-term enteral nutrition. The aim was to study the outcome of protocol-based PEG placement in a tertiary medical center. Materials and Methods All the patients who underwent PEG placement between January 2017 and December 2019 were included in the retrospective study. Study variables were entered into a uniform structured proforma. The procedure was done by two people using Ponsky-Gauderer pull-technique. Fluoroscopy guidance was considered for placement in special situations. Post-procedure, all the patients were regularly followed as per protocol to evaluate for adverse events. Results One hundred and eighteen patients with placement of PEG were included in the study. The mean age of the patients was 49.6 ± 7 years with 67.8% males. The most common indication of PEG was inability to swallow associated with head injury (43, 36.4%), followed by carcinoma esophagus (35, 29.8%) and stroke (24, 20.3%). Fluoroscopy was useful in 38 (32%) for PEG site identification. Tube dislodgement (16, 13.5%) and aspiration pneumonia (20, 16.9%) were the common adverse events. Age more than 60 years and dysphagia in neurologic disorders accounted for more than 60% of adverse events. Forty-nine (42%) of the PEG patients expired due to either primary illness or due to sepsis after a median time of 139 days (range: 32–288 days). There was no difference in the survival in patients with or without PEG-related complications (p = 0. 74). Conclusions Fluoroscopy assistance helps in accurate PEG placement in one third. Age > 60 years and dysphagia in neurologic disorders were independent risk factors associated with PEG tube complications.

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Outcomes of push and pull percutaneous endoscopic gastrostomy placements in 854 patients: A single‐center study

et al. 2021

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Background and Aims Percutaneous endoscopic gastrostomy (PEG) is indicated for prolonged enteral nutrition. This study aimed to analyze the outcome and to identify potential risk factors for complications in PEG procedures. Methods A single‐center retrospective analysis of the performed PEG procedures during the period January 2010 till January 2020. Results A PEG placement procedure was performed in 854 patients (64.1% male) and was successful in 833 (97.5%). In total, 513 push (61.6%) and 320 pull (38.6%) PEGs were placed. The mean age was 60.7 years, and the median follow‐up was 267 days. The push PEG was associated with peri‐procedural bleeding (P = 0.002) and tube dislodgements (P < 0.001), while the pull PEG was significantly associated with buried bumpers (P < 0.001), infected placement sites (P = 0.019), and granulation tissue formation (P = 0.044). The PEG‐related mortality rate was 0.2%, but the overall 30‐day mortality was 4.0%. Conclusion The current study showed that the push and pull PEG placements are both safe and feasible procedures, with a low PEG‐related mortality. Buried bumpers, infected placement sites, and granulation tissue formation are more often seen in the pull PEG, while the push PEG is associated with periprocedural bleeding and tube dislodgements. These complications should be taken into account and there is a need for a prospective trial to identify superiority between the PEG methods.

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Prediction of risk of adverse events related to percutaneous endoscopic gastrostomy: a retrospective study

Cited by 11 publications

References 30 publications

Predictive factors of complications and 30-day mortality in patients undergoing percutaneous endoscopic gastrostomy: the utility of C-reactive protein to albumin ratio

Predictive factors of complications and 30-day mortality in patients undergoing percutaneous endoscopic gastrostomy: the utility of C-reactive protein to albumin ratio

Fluoroscopy-Assisted Percutaneous Endoscopic Gastrostomy (F-PEG)—Single-Center Experience and Outcome

Outcomes of push and pull percutaneous endoscopic gastrostomy placements in 854 patients: A single‐center study

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