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.
Suzuki
Yutaka
Y
Department of Surgery, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan.
Tamez
Seryna
S
Murakami
Akihiko
A
Taira
Akihiko
A
Mizuhara
Akihiro
A
Horiuchi
Akira
A
Mihara
Chie
C
Ako
Eiji
E
Muramatsu
Hirohito
H
Okano
Hitoshi
H
Suenaga
Hitoshi
H
Jomoto
Kazuaki
K
Kobayashi
Junya
J
Takifuji
Katsunari
K
Akiyama
Kazuhiro
K
Tahara
Koh
K
Onishi
Koji
K
Shimazaki
Makoto
M
Matsumoto
Masami
M
Ijima
Masashi
M
Murakami
Masato
M
Nakahori
Masato
M
Kudo
Michiaki
M
Maruyama
Michio
M
Takahashi
Mikako
M
Washizawa
Naohiro
N
Onozawa
Shigeru
S
Goshi
Satoshi
S
Yamashita
Satoyoshi
S
Ono
Shigeki
S
Imazato
Shin
S
Nishiwaki
Shinji
S
Kitahara
Shuichirou
S
Endo
Takao
T
Iiri
Takao
T
Nagahama
Takeshi
T
Hikichi
Takuto
T
Mikami
Tatsuya
T
Yamamoto
Tetsuo
T
Ogawa
Tetsushi
T
Ogawa
Tomoko
T
Ohta
Tomoyuki
T
Matsumoto
Toshifumi
T
Kura
Toshiroh
T
Kikuchi
Tsutomu
T
Iwase
Tsuyoshi
T
Tsuji
Tsuyotoshi
T
Nishiguchi
Yukio
Y
Urashima
Mitsuyoshi
M
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