title: Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy.
abstract: Percutaneous endoscopic gastrostomy (PEG) is the preferred method for administration of long-term enteral tube feeding. However, most published studies describe only short-term follow-up in any detail. We report the long-term outcome and complication rate after PEG insertion in 49 patients (mean [SE] age 64 [2] years) whose mean length of PEG feeding was 175 days (range 30-560). Data were collected prospectively. PEG insertion was technically successful in all cases, with a procedure-related mortality of 2%. Early (< 30 days) mortality and morbidity were 8% and 22%, respectively. Of 45 patients surviving for more than 30 days, 76% were able to return home and 6 patients were eventually able to revert to oral feeding. There were 27 late complications: 2 site infections, 17 mechanical problems, and 8 episodes of gastrointestinal dysfunction. 51% of patients had no problems at all and 22% had 2 or more complications. 47% of complications required a hospital visit for resolution. Long-term enteral feeding by PEG was safe, effective, and had a low complication rate. Our patients were managed by a specialist nutrition team, a policy that may reduce the complication rate and hospital visits for patients being fed at home, and allow early discharge of dysphagic patients, thereby reducing costs.
authors.affiliation: Department of Medicine, University Hospital, Queen's Medical Centre, Nottingham, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Hull
authors.forename: J
authors.initials: J
authors.lastname: Rawlings
authors.forename: F E
authors.initials: FE
authors.lastname: Murray
authors.forename: J
authors.initials: J
authors.lastname: Field
authors.forename: A S
authors.initials: AS
authors.lastname: McIntyre
authors.forename: Y R
authors.initials: YR
authors.lastname: Mahida
authors.forename: C J
authors.initials: CJ
authors.lastname: Hawkey
authors.forename: S P
authors.initials: SP
authors.lastname: Allison
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000628:therapy; D003967:Diarrhea / Q000209:etiology; D016099:Endoscopy, Gastrointestinal; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D006701:Home Nursing; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors