Dementia and cognitive impairment are not associated with earlier mortality after percutaneous endoscopic gastrostomy.
BACKGROUND
Studies have shown varying results with regard to risk factors for mortality after percutaneous endoscopic gastrostomy (PEG).


OBJECTIVE
To examine the time to death in patients with dementia or significant cognitive impairment (SCI) due to neurologic injury who had undergone PEG compared with patients without either of these diagnoses, and to examine risk factors for 30-day mortality after PEG.


METHODS
Patients who had undergone PEG over a 2-year period were identified. Local medical records and the Social Security Death Index were reviewed to ascertain the patients' age, gender, serum albumin, diagnoses, presence or absence of dementia or SCI, presence or absence of complications related to PEG, and length of survival after PEG. The Charlson Comorbidity Index (CCI) was calculated based on the medical diagnoses at the time of PEG.


RESULTS
One hundred ninety patients were identified. Forty-five carried a diagnosis of dementia and/or SCI compared with 145 who did not. Median survival of patients with dementia or SCI was 53 days compared with 78 days in patients without these diagnoses (P=.85). Age (odds ratio [OR] 1.1, 95% confidence interval [CI] 1.04-1.12) and albumin (OR 0.43, 95% CI 0.22-0.84) were associated with 30-day mortality, whereas gender (OR 1.2, 95% CI 0.47-2.90), CCI (OR 1.1, 95% CI 0.86-1.32), and presence of PEG-related complications (OR 1.6, 95% CI 0.36-6.76) were not.


CONCLUSIONS
Age and serum albumin are risk factors for 30-day mortality after PEG. Patients with dementia or SCI do not have a significantly shorter survival after PEG than patients with intact cognitive function.
Gaines
David Isaac
DI
Division of Gastroenterology/Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Durkalski
Valerie
V
Patel
Alpesh
A
DeLegge
Mark H
MH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications; D003072:Cognition Disorders / Q000209:etiology / Q000401:mortality*; D003704:Dementia / Q000209:etiology / Q000401:mortality*; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012737:Sex Factors; D055815:Young Adult
D012709:Serum Albumin