[Prognosis factors of short and long-term survival in elderly hospitalized patients after percutaneous endoscopic gastrostomy].
OBJECTIVE
Percutaneous endoscopic gastrostomy (PEG) is the procedure of choice to achieve long-term enteral nutrition. The risks and benefits of PEG in elderly hospitalized patients have been poorly documented. The objective of this study was to describe the outcome of elderly patients one-year after insertion of a PEG tube.


METHODS
Hospital records of 73 patients who underwent PEG for enteral nutrition were reviewed retrospectively. Data on patient age and sex, preexisting medical conditions such as dementia or pressure sores, indication for PEG, concomitant infection, complications of PEG and death were obtained from the hospital charts.


RESULTS
The main indication for PEG was anorexia (49%). Before insertion of the gastrostomy tube, 44% of the patients had pressure scores, 30% had concomitant infection, 45% had dementia. PEG complications were observed in 51 patients. The survival rate at 1, 6 and 12 months was 0.68 [95% confidence interval - CI 95%: 0.56-0.78], 0.48 [CI 95%: 0.36-0.59] and 0.37 [CI 95%: 0.26-0.48] respectively. The presence of an infectious disease or of pressure sores at the time of PEG tube insertion were independently associated with mortality. Median survival of patients with these two factors was 32 days [CI 95%: 11-98].


CONCLUSIONS
According to these results, the PEG tubes should be inserted with a delay from infectious diseases and before the occurrence of pressure sores.
Service de Médecine Interne, Hôpital Albert Chenevier, Assistance Publique Hôpitaux de Paris, 40, rue Mesly, 94010 Créteil Cedex, France. elena.paillaud@ach.ap-hop-paris.fr
Elena
E
Paillaud
Phuong-Nhi
PN
Bories
Isabelle
I
Merlier
Jean-Philippe
JP
Richardet
Valérie
V
Jeanfaivre
Bernard
B
Campillo
D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000628:therapy; D003704:Dementia / Q000150:complications; D004750:Enteral Nutrition; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate