Percutaneous endoscopic gastrostomy; evidence of different prognosis in various patient subgroups.
BACKGROUND
As there are no prospective randomised trials about percutaneous endoscopic gastrostomy (PEG) insertion, the medical staff and caregivers encounter great difficulty in deciding when and if to perform this procedure.


OBJECTIVE
To explore which variables are associated with increased mortality after PEG insertion.


METHODS
Prospective observational study.


METHODS
Gastroenterological unit of a 500-bed community hospital.


METHODS
All patients over the age of 50 years referred for PEG insertion between January 1992 and December 2002.


METHODS
Patients were studied for their indication for PEG insertion as well as their main medical problems, and demographic details and medical records were reviewed yearly until mortality.


RESULTS
674 patients were enrolled (mean age 80.1 years, 42% men). The median survival was worst in diabetic patients (128 days, P <0.05), patients referred from hospital (161 days, P <0.01) and patients over the age of 80 years with dementia (171 days, P <0.001). The best median survival was found among demented patients under the age of 80 (467 days, P <0.05) and women under the age of 80 referred from nursing homes (780 days, P <0.01).


CONCLUSIONS
The outcome after PEG insertion is variable, with survival of over a year in many of the patients. These data are important for the medical staff, the patients and their caregivers when deciding about PEG placement.
Rimon
Ephraim
E
Department of Geriatrics, Gastroenterological Division, Kaplan-Harzfeld Medical Center, Rehovot, Israel. efraim_r@clalit.org.il
Kagansky
Nadya
N
Levy
Shmuel
S
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D003704:Dementia / Q000150:complications / Q000401:mortality*; D004750:Enteral Nutrition / Q000379:methods / Q000401:mortality*; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000379:methods / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis