Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study

Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. All patients who underwent PEG insertion or replacement were included. Detail...

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Bibliographic Details
Published in:Digestive and liver disease 2019-10, Vol.51 (10), p.1380-1387
Main Authors: Anderloni, Andrea, Di Leo, Milena, Barzaghi, Franco, Semeraro, Rossella, Meucci, Gianmichele, Marino, Roberta, Amato, Loretta, Frigerio, Mauro, Saladino, Valeria, Toldi, Anna, Manfredi, Guido, Redaelli, Alessandro, Feliziani, Marcella, De Roberto, Giuseppe, Boni, Francesca, Scacchi, Gianlorenzo, Mosca, Davide, Devani, Massimo, Arena, Monica, Massidda, Marco, Zanoni, Paolo, Ciscato, Camilla, Casini, Valentina, Beretta, Paolo, Forti, Edoardo, Salerno, Raffaele, Caramia, Vitantonio, Bianchetti, Mario, Tomba, Carolina, Evangelista, Andrea, Repici, Alessandro, Soncini, Marco, Maconi, Giovanni, Manes, Gianpiero, Gullotta, Renzo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Comorbidity
Complications
Enteral Nutrition - adverse effects
Enteral Nutrition - methods
Female
Gastrostomy - adverse effects
Gastrostomy - mortality
Humans
Italy - epidemiology
Logistic Models
Male
Middle Aged
Mortality
Multivariate Analysis
Patient Selection
PEG
Prospective Studies
Risk factors
Short-term outcome
Time Factors
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Summary:Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0–1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77−0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2019.03.024