Low serum albumin level is risk factor for patients with percutaneous endoscopic gastrostomy.
OBJECTIVE
In Japan, percutaneous endoscopic gastrostomy (PEG) has been used mainly in patients with stroke and dementia, who undertake oral ingestion voluntarily. We have used PEG for patients with various diseases in Saga Medical School Hospital, including postoperative recovery, malignant disease, and neurodegenerative diseases. This study evaluated prognostic factors in these patients regarding long-term survival.


METHODS
We analyzed retrospectively all patients who received PEG at our hospital. During the period of 1998-2007, 84 patients (32 females, 52 males; mean age, 60.3 years, range 20-89 years) were followed for more than 1 year. We analyzed sex, age, total lymphocyte count, serum albumin level, presence of malignant diseases, cerebrovascular diseases, neurodegenerative disorders, poor general condition after surgical procedures, dementia before PEG, pneumonia before PEG, and complications of PEG placement.


RESULTS
As for diseases, 23 patients had malignant diseases, 27 had cerebrovascular diseases, 19 had neurodegenerative disorders, 16 were in poor general condition after surgery for nonmalignant diseases, and 12 had dementia. Multivariate analysis indicated that risk factors for 1-year survival were low serum albumin level (≤2.9 g/dL), low lymphocyte count, and complications of malignant diseases. Low serum albumin level, low lymphocyte count, and malignant diseases were risk factors, and only the albumin level was a risk factor in those without malignant diseases.


CONCLUSIONS
Low serum albumin level was a risk factor for 1-year survival with PEG, which suggests that nutrient management before and during PEG placement should be monitored carefully.
Department of Internal Medicine, Saga Medical School, Saga.
Naoyuki
N
Tominaga
Ryo
R
Shimoda
Ryuichi
R
Iwakiri
Nanae
N
Tsuruoka
Yasuhisa
Y
Sakata
Hideo
H
Hara
Shinichiro
S
Hayashi
Shigeki
S
Morita
Yuhei
Y
Hamasaki
Toshio
T
Matsushima
Kohji
K
Miyazaki
Koichi
K
Node
Kazuma
K
Fujimoto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
D015415:Biomarkers; D012709:Serum Albumin