title: Predicting outcomes and complications of percutaneous endoscopic gastrostomy.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy (PEG) is the preferred route for long-term enteral feeding. Our aims were to prospectively evaluate the outcome ("PEG status") and complications of PEG and to determine whether these can be predicted by patients' baseline characteristics.
  
  
  METHODS
  We conducted a prospective study in two tertiary hospitals between August 2003 and January 2005, enrolling all patients who were undergoing PEG placement. We completed a questionnaire with details of demographic data, diagnosis, indication for PEG, Charlson's co-morbidity index, Barthel's index, laboratory tests, complications, and date and cause of death. Patients were followed at scheduled appointments. Univariate and multivariate analyses were performed.
  
  
  RESULTS
  168 patients (48% male, 52% female; mean age +/- standard deviation 74 +/- 16 years) underwent PEG using the pull technique. The main indication was neurogenic dysphagia (156 patients, 92.9%). Although most indications were appropriate, in half the cases these were established too late. There were no procedure-related deaths. Major complications occurred in four patients (2.4%); minor complications occurred in 52 patients (31%). No single variable could predict complications. Fifteen patients (9%) had the PEG removed. No single variable was independently associated with PEG removal. The mortality was 6.5% at 30 days, 17.3% at 90 days and 33.9% at 1 year. The C-reactive protein was the only predictive factor of early mortality (< or = 30 days), and Charlson's co-morbidity index was the only predictive factor of late mortality (> 30 days).
  
  
  CONCLUSIONS
  PEG placement is an easy and safe procedure, although it is often requested too late. No single variable could predict complications or PEG removal. C-reactive protein was found to be predictive of early mortality and Charlson's index was predictive of late mortality.
authors.affiliation: Gastroenterology Department, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil. faff@gbl.com.br
authors.forename: F A F
authors.initials: FA
authors.lastname: Figueiredo
authors.forename: M C
authors.initials: MC
authors.lastname: da Costa
authors.forename: A D
authors.initials: AD
authors.lastname: Pelosi
authors.forename: R N
authors.initials: RN
authors.lastname: Martins
authors.forename: L
authors.initials: L
authors.lastname: Machado
authors.forename: E
authors.initials: E
authors.lastname: Francioni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D003680:Deglutition Disorders / Q000601:surgery; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein