title: Patient outcomes related to percutaneous endoscopic gastrostomy placement.
abstract: Although many aspects of percutaneous endoscopic gastrostomy (PEG) have been addressed in the literature, attention to psychologic and social outcomes of PEG has been limited. Our goal was to assess a range of physical, psychologic, and social outcomes related to PEG feeding. This study is a follow-up survey of patients undergoing PEG and/or their surrogates. Data were collected by semistructured interviews in two tertiary hospitals in Alberta, Canada. Measurements consisted of PEG status at 1-year follow-up, quality of life, impact on caregivers, and opinions about long-term support via PEG. We included 71 patients in the study. Of all 39% of patients died, 32% had the PEG still in place, and for 28% the PEG was removed at the end of the 1-year follow-up. The prognosis of the attending physician at the initial visit and the underlying disease were significantly related to the outcome (p < 0.05). After 1 year, 85% of all patients whose PEGs were still in place, were not working or studying or managing their own household in any capacity, 67% were not managing personal care, and 19% were feeling very ill. Fifty-two percent of the caregivers spent 15 hours or more per week visiting and caring for the patient. At the 1-year follow-up, all ten surviving patients who could be interviewed agreed they would have a PEG again. Seventy percent of the caregivers said that they would want the same decision to be made. Although a majority of patients and caregivers did not regret the decision to place a PEG, this did not necessarily mean enhanced quality of life. Developing strategies to select patients who will benefit from long-term nutritional support could improve patient outcomes.
authors.affiliation: Department of Community Health Sciences and Medicine, Faculty of Medicine, University of Calgary, AB, Canada. mverhoef@ucalgary.ca
authors.forename: M J
authors.initials: MJ
authors.lastname: Verhoef
authors.forename: G M
authors.initials: GM
authors.lastname: Van Rosendaal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers; D004750:Enteral Nutrition / Q000401:mortality / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000401:mortality / Q000523:psychology; D005774:Gastrostomy / Q000401:mortality / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012867:Skin; D015996:Survival Rate; D016896:Treatment Outcome