Trends regarding percutaneous endoscopic gastrostomy

Abstract

Percutaneous endoscopic gastrostomy (PEG) is widely used in patients requiring long-term tube feeding. Traditional PEG studies usually focused on practical, technical, and ethical issues. There have been little epidemiological studies on PEG utilization and services in Asia. We evaluated the changes in PEG utilization, patient selection, patient characteristics, and medical service in Taiwan from 1997 to 2010.This retrospective study analyzed the data of patients admitted for PEG tube placement according to the International Classification of Diseases, Ninth Revision (procedure code 43.11) extracted from the National Health Insurance database between 1997 and 2010.From 1997 to 2010, the incidence of PEG increased from 0.1 to 3.8/105 population and incidence of PEG among aged patients increased from 0.9 to 19.0/105 population. Compared 1997–2004 to 2005–2010 periods, the percentage of cerebrovascular diseases decreased and esophageal cancer increased in the later period. PEG was mainly performed in male patients and at medical centers. Medical costs, Charlson Comorbidity Index (CCI) scores, and post-PEG mortality rates were higher in the 2005–2010 period than in the 1997–2004 period.PEG procedures are being increasingly performed in Taiwan, and changes in patient selection were noted. The seriousness of accompanying diseases, medical costs, and post-PEG mortality rates in patients undergoing PEG has increased. The present findings may help in the implementation of PEG, relocation of medical resources, and improvement of PEG-related care.

Gastrostomy Tube Use in the Critically Ill, 1994–2014

“…This algorithm has been used in prior literature to define critical illness as an alternative to simple admission to an ICU, (18)(19)(20), which can be influenced by local practice variation and ICU bed availability. We identified gastrostomies with previously validated (21) ICD-9-CM codes 43.1 (gastrostomy), 43.11 (percutaneous gastrostomy), 43.19 (other gastrostomy), and 44.32 (percutaneous gastrojejunostomy) (22)(23)(24). Patients that may have received gastrostomies for anatomic reasons unrelated to critical illness were excluded (i.e., face, head, neck, esophageal conditions) (see online supplement).…”

National trends in gastrostomy in older adults between 2014 and 2019 in Japan

“…12 In contrast, the incidence of PEG markedly increased from 1997 to 2010 in Taiwan, with increases in the severity of accompanying diseases, medical costs and post-PEG mortality rates. 13 In Japan, the number of PEG tube placements increased in the early 2000s, and studies using data sampled nationally reported that the number of gastrostomies peaked in 2010. 9,14 The number of gastrostomies has decreased since 2011, particularly among patients ≥85 years.…”

Semisolid vs Liquid Nutrients and 30‐Day Readmission in Gastrostomy Tube–Fed Patients: A Propensity‐Matched Analysis

“…Because of the lack of reliable evidence, Japanese guidelines do not strongly recommend the use of semisolid nutrients, stating that more evidence is needed to justify such a recommendation. 11 Given the global increase in patients receiving gastrostomy tube feeding, 21,22 more data on the effectiveness of semisolid nutrients would be beneficial not only in Japan but also in other countries for identifying optimal enteral feeding practices.…”