Percutaneous endoscopic gastrostomy: complications in the short and long-term follow-up and efficacy on nutritional status.

Abstract

Aim: Percutaneous endoscopic gastrostomy (PEG) is an accepted procedure for patients at risk of malnutrition, but it requires an invasive procedure and many complications can occur. The aim of this study is to evaluate the long-term efficacy, morbidity and mortality of PEG.

Methods: We analysed 68 inpatients who underwent a PEG procedure between January 1999 and August 2006 in our rehabilitation unit.

Results: A total of 26.5% of the examined patients died, but none of them due to PEG-related complications. Out of the 18 patients who died, 8 suffered from diabetes mellitus, thus showing a positive correlation between diabetes and mortality. The thirty-day mortality rate was of 1.5%; 30.9% of males and 23.1% of females developed an early peristomal infection, 4.4% of the patients suffered from stomal leakage, 1 patient pulled out the gastrostomy tube and 1 patient, accidentally, occurred to remove the tube. None major complication occurred. During the observation period nutritional parameters had been good in 10 patients, who had been followed for 33.3 +/- 16.1 months. These indexes were reduced with a significant statistical difference in deaed patients. Only 20.6% of the patients improved their autonomy, valued by Barthel index (BI), while in the other patients BI remained = 10.

Conclusions: This study confirmed the safety of PEG in terms of mortality and complications. The presence of diabetes mellitus increased mortality. The nutritional indexes were significantly reduced in deaed patients, while they remained good in the survivors. Nevertheless, a good nutrition had the slightest influence on the functional status.