Long-term risk associations of percutaneous endoscopic gastrostomy and nasogastric tubes: A population-based cohort study

IF 0.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
Chung-Hung Chen, Sheng-Lei Yan, Chun-Hsiang Wang, Yung-Hsiang Yeh, Chien-Hua Chen, Yueh-Tsung Lee, Yuan-Tsung Tseng
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Abstract

Percutaneous endoscopic gastrostomy (PEG) and nasogastric (NG) tubes are commonly used for long-term enteral feeding in older patients with swallowing difficulties. We conducted a nationwide cohort study (2002–2018) comparing complications between PEG and NG tubes using a 1:1 new-user design. Post-procedure outcomes included peritonitis, peptic ulcer, gastrointestinal bleeding, and aspiration pneumonia. The incidence rates per 1000 person-years for PEG versus NG groups were 3.52 versus 4.53 for peritonitis, 4.67 versus 8.62 for peptic ulcer, 7.65 versus 8.59 for GI bleeding, and 15.4 versus 9.04 for aspiration pneumonia. After adjusting for confounders, PEG was not associated with significant risks compared to NG. However, patients with chronic kidney disease (CKD) had a higher risk of aspiration pneumonia with PEG feeding (HR 3.03, 95% CI 1.02–8.99). Our findings suggest that PEG is the recommended approach for patients needing extended tube feeding support and careful patient selection and close monitoring, especially for CKD patients, are crucial post-PEG placement. These real-world data contribute to clinical decision-making on enteral access options, but further studies on interventions to reduce complications are needed.

Abstract Image

经皮内镜胃造口术和鼻胃管的长期风险关联:一项基于人群的队列研究
经皮内镜胃造口术(PEG)和鼻胃管(NG)通常用于长期肠内喂养高龄吞咽困难患者。我们进行了一项全国性队列研究(2002-2018),使用1:1的新用户设计比较PEG和NG管的并发症。术后结果包括腹膜炎、消化性溃疡、胃肠道出血和吸入性肺炎。PEG组与NG组每1000人年的发病率分别为:腹膜炎3.52 vs 4.53,消化性溃疡4.67 vs 8.62,胃肠道出血7.65 vs 8.59,吸入性肺炎15.4 vs 9.04。在调整混杂因素后,与NG相比,PEG与显著风险无关。然而,慢性肾脏疾病(CKD)患者使用PEG喂养时吸入性肺炎的风险更高(HR 3.03, 95% CI 1.02-8.99)。我们的研究结果表明,对于需要延长管喂养支持的患者,PEG是推荐的方法,仔细选择患者并密切监测,特别是CKD患者,是PEG后放置的关键。这些真实数据有助于肠内通路选择的临床决策,但需要进一步研究减少并发症的干预措施。
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来源期刊
Advances in Digestive Medicine
Advances in Digestive Medicine GASTROENTEROLOGY & HEPATOLOGY-
自引率
33.30%
发文量
42
期刊介绍: Advances in Digestive Medicine is the official peer-reviewed journal of GEST, DEST and TASL. Missions of AIDM are to enhance the quality of patient care, to promote researches in gastroenterology, endoscopy and hepatology related fields, and to develop platforms for digestive science. Specific areas of interest are included, but not limited to: • Acid-related disease • Small intestinal disease • Digestive cancer • Diagnostic & therapeutic endoscopy • Enteral nutrition • Innovation in endoscopic technology • Functional GI • Hepatitis • GI images • Liver cirrhosis • Gut hormone • NASH • Helicobacter pylori • Cancer screening • IBD • Laparoscopic surgery • Infectious disease of digestive tract • Genetics and metabolic disorder • Microbiota • Regenerative medicine • Pancreaticobiliary disease • Guideline & consensus.
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