Percutaneous endoscopic gastrostomy for enteral nutrition: a 5-year clinical experience with 324 patients

Yoon, Ezekiel Wong Toh; Yoneda, Kaori; Nishihara, Kazuki

doi:10.23736/s1121-421x.18.02535-7

Cited by 6 publications

(4 citation statements)

References 31 publications

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“…studied gastrointestinal bleeding after PEG in Japan but did not examine bleeding from skin incisions or prognostic factors 20 . In the retrospective study by Toh Yoon et al ., the death rate within 30 days after PEG placement was very high at 6.8%, which is different from other reported death rates 4 . A recent single‐center, university hospital study reported that steroid use can cause serious complications.…”

Section: Discussioncontrasting

confidence: 65%

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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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Section: Discussioncontrasting

confidence: 65%

“…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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“…This may be due to lower AWT being associated with lower BMI and malnutrition [11]. A better nutritional status is important for better survival [7,9,10,15,21]. Therefore, AWT may help assess nutritional status and predict survival in dysphagic patients with PEG.…”

Section: Discussionmentioning

confidence: 99%

“…A lower BMI is associated with an increased risk of mortality after PEG [9]. Serum albumin (Alb) and total lymphocyte count (TLC), which are indicators of nutritional status, are also prognostic factors after PEG [7,10]. Therefore, assessment of nutritional status is crucial for better nutritional intervention and improving patient prognosis.…”

Section: Introductionmentioning

confidence: 99%

Nutritional and prognostic significance of abdominal wall thickness measured during percutaneous endoscopic gastrostomy in older individuals with dysphagia

Masaki

Kimura

2021

Clinical Nutrition ESPEN

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Background & aims: The significance of abdominal wall thickness (AWT) for nutritional assessment remains unclear. This study aimed to evaluate the nutritional and prognostic significance of AWT measured during percutaneous endoscopic gastrostomy (PEG) in older patients with dysphagia. Methods: This single-center retrospective cohort study enrolled older adults with dysphagia who underwent PEG for enteral nutrition using the introducer technique between February 2010 and January 2019. We examined the association between AWT measured during PEG and nutritional status items, including body mass index (BMI), serum albumin (Alb), total lymphocyte count (TLC), total cholesterol (TC), hemoglobin (Hb), and C-reactive protein (CRP). The shaft length of the PEG tube inserted, which is an approximation value of the AWT, was used for statistical analysis. Patients were divided into three groups: low-AWT group (shaft length 2.5 cm), medium-AWT group (shaft length 3.0e3.5 cm), and high-AWT group (shaft length !4.0 cm). We performed the KruskaleWallis test and multiple linear regression analysis with multiple imputation. We performed survival analysis using the KaplaneMeier method, log-rank test, and Cox regression analysis. Results: A total of 520 patients were identified: 115, 258, and 147 patients in the low-AWT, medium-AWT, and high-AWT groups, respectively. Higher AWT was significantly associated with higher BMI, Alb, TLC, TC, Hb, and lower CRP levels. Multiple linear regression analysis revealed that BMI and TLC were significant predictors of AWT (BMI: coefficient 1.16E-01, 95% confidence interval [CI], 9.77E-02e1.33E-01, P < 0.001; TLC: coefficient 1.18E-04, 95% CI, 2.72E-05e2.09E-04, P ¼ 0.011). The median survival time was the longest in the high-AWT group (low-AWT, 359 days; medium-AWT, 851 days; high-AWT, 1662 days; P < 0.001). The hazard ratio for the high-AWT group relative to the medium-AWT group was 0.59 (95% CI, 0.41e0.85, P ¼ 0.004), and that relative to the low-AWT group was 0.34 (95% CI, 0.24e0.51, P < 0.001). Conclusions: Higher AWT was associated with better nutritional status and survival. AWT may help assess nutritional status and predict survival in older dysphagic patients with PEG.

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Enteral tube feeding for people with severe dementia

Davies

Barrado‐Martín

Vickerstaff

et al. 2021

Cochrane Database of Systematic Reviews

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Percutaneous endoscopic gastrostomy for enteral nutrition: a 5-year clinical experience with 324 patients

Cited by 6 publications

References 31 publications

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

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

Nutritional and prognostic significance of abdominal wall thickness measured during percutaneous endoscopic gastrostomy in older individuals with dysphagia

Enteral tube feeding for people with severe dementia

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