title: Dementia and cognitive impairment are not associated with earlier mortality after percutaneous endoscopic gastrostomy.
abstract: 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.
authors.affiliation: Division of Gastroenterology/Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
authors.forename: David Isaac
authors.initials: DI
authors.lastname: Gaines
authors.forename: Valerie
authors.initials: V
authors.lastname: Durkalski
authors.forename: Alpesh
authors.initials: A
authors.lastname: Patel
authors.forename: Mark H
authors.initials: MH
authors.lastname: DeLegge
mesh_terms: 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
chemical_list: D012709:Serum Albumin