Effect of discontinuing antithrombotic drugs in patients undergoing percutaneous endoscopic gastrostomy

Narita, Toru; Murase, Hiromi; Yoneda, Godai; Iwasaki, Kei; Miyazaki, Shojiro

doi:10.11641/pde.94.1_32

Cited by 2 publications

(4 citation statements)

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“…All patients who experienced bleeding in the present study had undergone PEG construction using the modified introducer method. Although the number of cases was small, the present result is consistent with previous research 4 . However, the pull method is challenging to carry out in all patients.…”

Section: Discussionsupporting

confidence: 91%

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Risk factors for perioperative bleeding in percutaneous endoscopic gastrostomy construction: A case series and retrospective preliminary investigation

Nishida

Hara

et al. 2020

Geriatrics Gerontology Int

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Objectives: Percutaneous endoscopic gastrostomy (PEG) is one of the methods of tube feeding in patients who are incapable of oral intake. There are no reports on risk factors for bleeding at PEG construction. Our main objective was to investigate the risks and predictors of bleeding associated with PEG construction. Methods: This retrospective, observational study included patients who had undergone PEG construction at our institution. To investigate the risks of bleeding associated with PEG construction, we compared the baseline characteristics between bleeding and non-bleeding patients. In terms of early predictors of post-PEG bleeding, we evaluated whether there had been a decrease from baseline of >10% in hemoglobin levels on the day after the procedure. Results: The median preoperative albumin levels were 22.5 g/L (range 20-29 g/L) and 30 g/L (range 18-40 g/L) in the bleeding and non-bleeding groups, respectively (P = 0.014, Mann-Whitney U-test). The median preoperative platelet counts were 177 500 (range 87 000-265 000) and 271 000 (83 000-749 000) in the bleeding and non-bleeding groups, respectively (P = 0.043, Mann-Whitney U-test). The number of patients for whom hemoglobin levels decreased >10% from baseline on the day after the procedure differed significantly between the bleeding and non-bleeding groups (2/4, 50% and 3/58, 5.45%), respectively (P = 0.002, Pearson's χ 2-test). Conclusions: Low serum albumin and preoperative platelet counts might be risk factors for bleeding. Rigorous follow up is necessary for patients showing a decrease in hemoglobin level ≥10% of their baseline the day after the procedure.

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Section: Discussionsupporting

confidence: 91%

“…Although the number of cases was small, the present result is consistent with previous research. 4 However, the pull method is challenging to carry out in all patients. A 20-Fr PEG tube might not pass through in patients with passage obstruction as a result of a pharyngolaryngeal esophageal tumor.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for perioperative bleeding in percutaneous endoscopic gastrostomy construction: A case series and retrospective preliminary investigation

Nishida

Hara

et al. 2020

Geriatrics Gerontology Int

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“…Narita et al . reported that thromboembolism did not occur during antiplatelet withdrawal during the perioperative period of PEG 1 . Morishita et al .…”

Section: Introductionmentioning

confidence: 99%

“…Percutaneous endoscopic gastrostomy (PEG) is performed in many hospitals in Japan. However, reports of postoperative bleeding or early postoperative death after PEG are limited 1–5 …”

Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative bleeding and early death in percutaneous endoscopic gastrostomy: A multicenter retrospective study

Takeuchi

Masuda

et al. 2021

J of Gastro and Hepatol

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Background and Aim Comprehensive reports on the risk factors for bleeding and early death after percutaneous endoscopic gastrostomy (PEG) are limited. In this multicenter study, we retrospectively investigated the risk factors for bleeding and early death after PEG. Methods Patients (n = 1234) who underwent PEG between 2015 and 2020 at Osaka Medical and Pharmaceutical University and its affiliated hospitals (11 institutions in total) were evaluated for postoperative bleeding and early death (within 60 days) after PEG according to patient characteristics, construction method, medical history, medications, preoperative hematological findings, and perioperative adverse events. Multivariate logistic regression was performed to identify independent predictors of bleeding and early death after PEG. Results The risk factors for bleeding after PEG were PEG tube insertion using the modified introducer method (odds ratio [OR], 4.37; P = 0.0003), low platelet count (OR, 0.99; P = 0.014), antiplatelet therapy (OR, 2.11; P = 0.036), and heparinization (OR, 4.50; P = 0.007). Risk factors for early death were low body mass index (BMI) (OR, 0.89; P = 0.015), low serum albumin levels (OR, 0.50; P = 0.035), and comorbidity of active cancer (OR, 4.03; P < 0.0001). There was no significant association between bleeding and early death after PEG. Conclusions We identified several risk factors for bleeding and early death after PEG. Risk factors for bleeding were PEG tube insertion using the modified introducer method, low platelet count, antiplatelet therapy, and heparinization. Risk factors for early death were low BMI, low serum albumin levels, and comorbidity of active cancer.

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Effect of discontinuing antithrombotic drugs in patients undergoing percutaneous endoscopic gastrostomy

Cited by 2 publications

References 1 publication

Risk factors for perioperative bleeding in percutaneous endoscopic gastrostomy construction: A case series and retrospective preliminary investigation

Risk factors for perioperative bleeding in percutaneous endoscopic gastrostomy construction: A case series and retrospective preliminary investigation

Risk factors for postoperative bleeding and early death in percutaneous endoscopic gastrostomy: A multicenter retrospective study

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