[Percutaneous endoscopic gastrostomy in elderly patients. A prospective study in a geriatric hospital].
OBJECTIVE
The purpose of this work was to search for prognostic factors after percutaneous endoscopic gastrostomy (PEG) for enteral nutrition in geriatric patients by studying complications, nutritional benefits, and impact on quality of life.


METHODS
In this prospective study, 59 elderly patients referred for PEG were followed for 1 year or until tube removal or death. Complications, tolerance to enteral nutrition, nutritional status, infection, bedsores and quality of life were assessed by a questionnaire at tube insertion, at 1 month and every 3 months. Multivariate analysis was performed to look for factors predictive of early mortality before one month.


RESULTS
Insertion of the PEG tube was always successful. Pneumonia in the week before tube insertion was predictive of early mortality (odds-ratio: 8.77 [1.63-47.2], P=0.01). Thirty-day mortality was 25%, but was never related to PEG tube insertion. During follow up, no local complication was observed and enteral feeding was well tolerated. After 3 months, serum albumin and prealbumin levels increased (P<0.001). There were fewer infections (P<0.001) and bedsores remained unchanged. Quality-of-life scores were not modified. At one year, the PEG tube was removed in 16 patients who resumed normal oral nutrition, and 6 other patients were able to return to their home.


CONCLUSIONS
In a cohort of aged institutionalized patients, PEG for enteral nutrition was well tolerated and not definitive in more than one-quarter of them. Active lung infection is a risk factor of early mortality.
Hôpital Charles Foix, 7, avenue de la République, 94205 Ivry-sur-Seine Cedex, France. vered@club-internet.fr
Vered
V
Abitbol
Hana
H
Selinger-Leneman
Yves
Y
Gallais
François
F
Piette
Jean-Pierre
JP
Bouchon
Jean-Bernard
JB
Piera
Jean-Yves
JY
Beinis
Mireille
M
Laurent
Robert
R
Moulias
Marianne
M
Gaudric
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000704:Analysis of Variance; D004750:Enteral Nutrition; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects; D005853:Geriatrics; D006761:Hospitals; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D009752:Nutritional Status; D011014:Pneumonia / Q000150:complications / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires