Percutaneous endoscopic gastrostomy and early mortality.
To assess morbidity, mortality, and benefit associated with percutaneous endoscopic gastronomy (PEG), we retrospectively studied 42 patients who had had PEG. Mortality was exceptionally high during the first 60 days after PEG (43%), and then stabilized. In nearly half of the cases (20/42) the PEG tube was removed during the first 60 days because of either death or improvement. Patients with malignancy had a significantly higher morbidity and 60-day mortality than the neurologically impaired. We concluded that patients should be carefully selected for PEG because early mortality is high; a 60-day trial of soft nasogastric feedings should be considered before PEG, and could reduce by nearly half the number of patients failing to receive long-term benefit; and patients with malignancy have significantly greater morbidity and mortality after PEG and may not receive the same advantage from the procedure.
Clarkston
W K
WK
Department of Gastroenterology, University of Missouri, Kansas City School of Medicine.
Smith
O J
OJ
Walden
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D004750:Enteral Nutrition / Q000379:methods*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000601:surgery; D009422:Nervous System Diseases / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors