Factors associated with achieving adequate caloric delivery immediately after percutaneous endoscopic gastrostomy: a retrospective observational study.

Abstract

Objective: Failure to achieve adequate caloric intake is common after percutaneous endoscopic gastrostomy (PEG) and may contribute to progressive malnutrition in older adults. This study aimed to identify factors associated with achieving adequate caloric delivery early after PEG placement.

Methods: This single-center retrospective observational study included patients aged ≥65 years who underwent PEG between January 2022 and December 2024. Target caloric intake was determined based on basal energy expenditure (BEE). The target nutritional intake achievement rate (TaNIAR) was defined as the ratio of final delivered calories to BEE. Patients were classified into an underfeeding group (TaNIAR <100%) and an appropriate-feeding group (TaNIAR ≥100%). Multivariable logistic regression analysis was performed to identify factors independently associated with achieving TaNIAR ≥100%.

Results: Fifty-nine patients were analyzed; 15 were classified as underfeeding and 44 as appropriate-feeding. The median final caloric intake, calculated in increments of 300 kcal corresponding to the packet size of the enteral formula, was 1,200 kcal (range, 600-1,200 kcal) in the underfeeding group and 1,200 kcal (range, 900-1,400 kcal) in the appropriate-feeding group. Multivariable analysis identified the use of a pectin-containing oligomeric formula (POF) (odds ratio [OR], 32.8; 95% confidence interval [CI], 3.7-292.9) and BEE ≤990 kcal/day (OR, 29.5; 95% CI, 3.1-277.7) as factors independently associated with achieving TaNIAR ≥100%. The final caloric intake clustered within a relatively narrow range in both groups.

Conclusion: Lower BEE and the use of POF were independently associated with achieving adequate caloric delivery after PEG placement. Optimization of enteral formula selection may represent a practical strategy to improve early nutritional adequacy in older patients. Further prospective studies are required to validate these findings.