Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan.
OBJECTIVE
To examine the long term survival of geriatric patients treated with percutaneous endoscopic gastrostomy (PEG) in Japan.


METHODS
We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient's characteristics at PEG using log-rank tests and Cox proportional hazard models.


RESULTS
Nine hundred and thirty one patients were followed up for a median of 468 d. A total of 502 deaths were observed (mortality 53%). However, 99%, 95%, 88%, 75% and 66% of 931 patients survived more than 7, 30, 60 d, a half year and one year, respectively. In addition, 50% and 25% of the patients survived 753 and 1647 d, respectively. Eight deaths were considered as PEG-related, and were associated with lower serum albumin levels (P = 0.002). On the other hand, among 28 surviving patients (6.5%), PEG was removed. In a multivariate hazard model, older age [hazard ratio (HR), 1.02; 95% confidence interval (CI), 1.00-1.03; P = 0.009], higher C-reactive protein (HR, 1.04; 95% CI: 1.01-1.07; P = 0.005), and higher blood urea nitrogen (HR, 1.01; 95% CI: 1.00-1.02; P = 0.003) were significant poor prognostic factors, whereas higher albumin (HR, 0.67; 95% CI: 0.52-0.85; P = 0.001), female gender (HR, 0.60; 95% CI: 0.48-0.75; P < 0.001) and no previous history of ischemic heart disease (HR, 0.69; 95% CI: 0.54-0.88, P = 0.003) were markedly better prognostic factors.


CONCLUSIONS
These results suggest that more than half of geriatric patients with PEG may survive longer than 2 years. The analysis elucidated prognostic factors.
Department of Surgery, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan.
Yutaka
Y
Suzuki
Seryna
S
Tamez
Akihiko
A
Murakami
Akihiko
A
Taira
Akihiro
A
Mizuhara
Akira
A
Horiuchi
Chie
C
Mihara
Eiji
E
Ako
Hirohito
H
Muramatsu
Hitoshi
H
Okano
Hitoshi
H
Suenaga
Kazuaki
K
Jomoto
Junya
J
Kobayashi
Katsunari
K
Takifuji
Kazuhiro
K
Akiyama
Koh
K
Tahara
Koji
K
Onishi
Makoto
M
Shimazaki
Masami
M
Matsumoto
Masashi
M
Ijima
Masato
M
Murakami
Masato
M
Nakahori
Michiaki
M
Kudo
Michio
M
Maruyama
Mikako
M
Takahashi
Naohiro
N
Washizawa
Shigeru
S
Onozawa
Satoshi
S
Goshi
Satoyoshi
S
Yamashita
Shigeki
S
Ono
Shin
S
Imazato
Shinji
S
Nishiwaki
Shuichirou
S
Kitahara
Takao
T
Endo
Takao
T
Iiri
Takeshi
T
Nagahama
Takuto
T
Hikichi
Tatsuya
T
Mikami
Tetsuo
T
Yamamoto
Tetsushi
T
Ogawa
Tomoko
T
Ogawa
Tomoyuki
T
Ohta
Toshifumi
T
Matsumoto
Toshiroh
T
Kura
Tsutomu
T
Kikuchi
Tsuyoshi
T
Iwase
Tsuyotoshi
T
Tsuji
Yukio
Y
Nishiguchi
Mitsuyoshi
M
Urashima
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria; D001806:Blood Urea Nitrogen; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007564:Japan; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
D002097:C-Reactive Protein