Endoscopy 2020; 52(S 01): S186
DOI: 10.1055/s-0040-1704579
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 14:30 – 15:00 Percutaneous Endoscopic Gastrostomy (PEG) ePoster Podium 6
© Georg Thieme Verlag KG Stuttgart · New York

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY PLACEMENT - WHAT ARE THE RISK FACTORS FOR POOR OUTCOMES?

R Patel
1   Royal Free London NHS Trust, London, United Kingdom
,
R Cama
1   Royal Free London NHS Trust, London, United Kingdom
,
S Moledina
1   Royal Free London NHS Trust, London, United Kingdom
,
K Besherdas
1   Royal Free London NHS Trust, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims Percutaneous endoscopic gastrostomy (PEG) is a relatively safe well-established procedure to permit long term enteral feeding in patients with swallowing difficulties. However, there is a significant procedure-related and all-cause mortality risk. Controversy still remains regarding patient selection and optimal timing for the procedure. We aimed to identify risk factors associated with length of stay and mortality following PEG placement.

Methods We performed a retrospective study at a tertiary London-based hospital Trust. Endoscopy software (Unisoft GI reporting tool) was used to identify the last 100 patients to have a PEG placed in reverse chronological order from December 2018. Endoscopy reports were reviewed for indication. Electronic patient records were used to identify functional status prior to procedure, length of stay and mortality. Chest radiograph reports were reviewed for evidence of consolidation at the time of procedure. Serum markers including white cell count, creatinine and albumin were noted.

Results 100 patients had a PEG placed between February 2017 and December 2018.

Tab. 1

12 month outcomes after insertion of PEG.

12 month mortality (n=33)

12 month survival (n=67)

*p value

Independent ADLs

9 (27.3)

42 (62.7)

0.0009

Consolidation (Y)

16 (48.5)

7 (10.4)

0.00002

WCC

11.3 (4 - 37)

8.3 (3.6 - 17.3)

0.0004

Albumin

28.3 (18 - 35)

34.4 (15 - 49)

<0.0001

Conclusions After admission, patients wait over a month to have PEG placement and total length of stay is over 2 months. Only half of patients are independent at time of PEG placement. Older age and lack of independence for activities of daily living are associated with higher mortality at 12 months after PEG placement. Consolidation on chest radiograph, leucocytosis and low albumin are significantly associated with mortality at 12 months. We conclude that patient selection for PEG placement should consider resolution of radiological and serological abnormalities.