Nutritional status and quality of life in patients with percutaneous endoscopic gastrostomy (PEG) in practice: prospective one-year follow-up.
Sixty patients (age 73 +/- 14 years; 22 women, 38 men) with dysphagia (67% neurological diseases, 33% tumors) were followed up for 1 year after placement of a percutaneous endoscopic gastrostomy (PEG). Before PEG placement and at six appointments thereafter, the patients' nutritional status was measured using bioelectric impedance analysis (BIA) and hematological nutritional parameters. A validated questionnaire was used to assess quality of life (the Gastrointestinal Quality of Life Index, GIQLI). The overall mortality rate was 65%, and mortality during the hospitalization period was 22%. Depending on the duration of the dysphagia, marked nutritional deficits were observed at the start of the study (deficiencies in albumin in 49% of the patients, calcium in 15%, magnesium in 18%, retinol in 78%, alpha-tocopherol in 16%, folic acid in 16%, vitamin B12 in 8%, vitamin D in 40%, and zinc in 46%). With the exception of vitamin E, all parameters returned to normal during the follow-up period. At the start of the study, BIA indicated nutritional deficiency in 90% of the patients, with no overall improvement being observed during the follow-up period. The GIQLI scores, on average, reached a figure of 61% of an unrestricted quality of life. In conclusion, long-term nutrition via the PEG tube maintained the patients' quality of life. For BIA most patients were malnourished during the follow-up period, but nevertheless PEG feeding was enough to compensate for gross nutritional deficiencies. Not infrequently, the indication for PEG placement is established too late.
Klose
Joachim
J
Ludwig Maximilian University, Munich, Germany. jklose@medinn.med.uni-muenchen.de
Heldwein
Walter
W
Rafferzeder
Michael
M
Sernetz
Frederike
F
Gross
Manfred
M
Loeschke
Klaus
K
D000368:Aged; D000369:Aged, 80 and over; D017097:Electric Impedance; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000175:diagnosis / Q000628:therapy*; D009752:Nutritional Status; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors