Risk Factors Associated With Early Mortality After Percutaneous Endoscopic Gastrostomy in Patients at a Tertiary Care Center in Brazil: A Retrospective Single-Center Survival Study

Abstract

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is the main accepted method for long-term tube feeding. OBJECTIVE: To investigate the risk factors associated with early mortality after PEG. METHODS: Retrospective survival analysis in a tertiary-level center in Recife, Brazil. We reviewed the medical records of 150 patients with PEG placement. The data were analysed by the Kaplan-Meier method. Multivariable Cox proportional regression models were also built to test the effects of PEG on mortality. RESULTS: A total of 150 patients who submitted to PEG were studied (70 male). Of the participants, 87 (58%) had blood hypertension; 51 (34%) patients had diabetes; 6 (4%) patients had chronic renal disease; and 6 (4%) had malignancy. Chronic neurodegenerative diseases were the more common clinical indication for PEG. The 30-day and 60-day proportional mortality probability rates were 11.05% and 15.34% respectively. A multivariate Cox proportional regression model, haemoglobin (HR 4.39, 95%CI 1.30-14.81, P=0.017) and pre-procedure UCI staying (HR 0.66, 95% CI 0.50-0.87, P=0.004) were significant predictors of early mortality.A haemoglobin cut-off value of 10.05 g/dL was shown to have a sensibility of 82.6% (61.2% to 95% CI) and an acceptable sensitivity of 59.0 (50.6% to68.6% CI), and a likelihood ratio of 2.06 for eight weeks mortality. CONCLUSION: In patients who had been subjected to the PEG procedure for long-term nutrition, low haemoglobin, pre-procedure intensive care unit internment or both are associated with the risk of early mortality.

Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy

“…Our previous study with preliminary data and 150 patients revealed that hemoglobin lower than 10 mg/dL and preoperative ICU hospitalizations as predictors of mortality in eight weeks. 23 This was the first study to demonstrate these factors as predictors, but we did not have a proper sample to evaluate mortality in four weeks at the time. The present study with almost double the patients allowed us to proper evaluate four-week mortality leading us to confirm that the same factors were associated with mortality.…”

Factors associated with length of stay and death in tube‐fed patients: A cross‐sectional multicentre study

“…Several studies have shown the association between long‐term enteral access devices and early mortality (Johnston et al., 2008 ; Miranda et al., 2019 ; Pih et al., 2018 ) in critically ill patients (Vest et al., 2018 ). In addition, the association between LOS and enterally tube‐fed critically ill patients has also been reported (Anziliero & Beghetto, 2018 ; Atasever et al., 2018 ; Ortega et al, 2017 ).…”

“…Several studies have shown the association between long-term enteral access devices and early mortality (Johnston et al, 2008;Miranda et al, 2019;Pih et al, 2018) in critically ill patients (Vest et al, 2018).…”

Experiences with PEG practices in patients with early- and late-period complications

“…[12,18,23] Almost all of the reported causes of mortality are related to the primary disease of the patient; PEG-associated mortality is close to zero in all studies, while procedurerelated mortality is reported as being 0.5-2%. [12,24] Previous research has defined certain factors associated with post-PEG mortality. Arora et al [18] found PEG indications to be closely correlated to mortality.…”