title: Long-term outcome following placement of percutaneous endoscopic gastrostomy in younger and older patients.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy (PEG) is the method of choice in maintaining enteral nutrition in patients with swallowing and nutritional disorders of different etiology. The aim of this study was to assess the long-term outcome of patients following placement of a PEG.
  
  
  METHODS
  All patients who received a PEG between October 1999 and September 2000 were included in this prospective study. Long-term function, replacement or removal of the PEG, complications and survival of the patients were analyzed in group A (younger than 75 years) and group B (75 years or older).
  
  
  RESULTS
  The indications for PEG placement in group A (54 patients, mean age 54.5 years) were neurological (66.7%) and malignant (31.5%) disorders, whereas in group B (40 patients, mean age 81 years) the indications were predominantly neurological diseases (87.5%). The majority of patients (91 of 94 patients; 96.8%) could be followed long term or until death. In group A, 46 patients (85.2%) had uncomplicated long-term function of their PEG and interventions were necessary in only 8 patients. Removal of the PEG was possible during the course in 17 patients (31.5%). In group B, uncomplicated long-term function was observed in 34 patients (85%) and interventions were required in only 6 patients. Removal of the PEG was not possible in group B. Survival rates for 1-, 2- and 5 years in group A were 73.9%, 61.8% and 43.9%, respectively, and in group B 41.4%, 31.9% and 15.9%, respectively; the difference was statistically significant (p=0.002).
  
  
  CONCLUSIONS
  Excellent long-term function of PEG was seen in this study of 94 consecutive patients, and interventions were necessary only in a minority of patients. The prognosis for older patients was worse; however, the 2-year survival rate of 32% justified the PEG insertion.
authors.affiliation: Department of Medicine, General Hospital Grieskirchen, Austria. andreas.kirchgatterer@khgr.at
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirchgatterer
authors.forename: Christian
authors.initials: C
authors.lastname: Bunte
authors.forename: Gerhard
authors.initials: G
authors.lastname: Aschl
authors.forename: Eva
authors.initials: E
authors.lastname: Fritz
authors.forename: Dietmar
authors.initials: D
authors.lastname: Hubner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kranewitter
authors.forename: Manfred
authors.initials: M
authors.lastname: Fleischer
authors.forename: Maximilian
authors.initials: M
authors.lastname: Hinterreiter
authors.forename: Bernhard
authors.initials: B
authors.lastname: Stadler
authors.forename: Peter
authors.initials: P
authors.lastname: Knoflach
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome