title: Predictive factors of mortality after PEG insertion: guidance for clinical practice.
abstract: BACKGROUND
  Percutaneous endoscopic gastrostomy (PEG) is considered the preferred route for long-term enteral feeding. The aim of this study was to determine predictors of an increased mortality risk after PEG insertion.
  
  
  METHODS
  A retrospective study was conducted during a 13-year period in the gastroenterology department of Erlangen University Hospital. The authors completed a questionnaire with details of demographic data, diagnosis, indication for PEG, type of tube, and cause of death. Patients were contacted regularly at scheduled appointments.
  
  
  RESULTS
  In total, 787 patients (574 male [72.9%]) underwent PEG placement by the pull technique. The main underlying disease was malignant (75.6%). By the end of the study period, 614 patients had died. The average survival time was 720 days. The 30-, 60-, 90-day and 1-, 3-, and 5-year mortality rates amounted to 6.5%, 9.8%, 13%, 32.1%, 59.3%, and 69.8%, respectively. Predictive factors of increased 30-day mortality were higher age, lower body mass index (BMI), and the presence of diabetes mellitus. The presence of all 3 variables served as an indicator to detect high-risk patients, with a sensitivity of 0.80 and a specificity of 0.64.
  
  
  CONCLUSIONS
  Mortality predictors for patients after PEG insertion are higher age, lower BMI, and the presence of diabetes mellitus. To avoid unnecessary and dangerous examinations in high-risk patients, the above-mentioned predictive factors of mortality should be checked before PEG placement.
authors.affiliation: Department of Medicine 1, University Hospital Erlangen-Nuremberg, Erlangen, Germany. yurdaguelzopf@uk-erlangen.de
authors.forename: Yurdagül
authors.initials: Y
authors.lastname: Zopf
authors.forename: Jürgen
authors.initials: J
authors.lastname: Maiss
authors.forename: Peter
authors.initials: P
authors.lastname: Konturek
authors.forename: Christina
authors.initials: C
authors.lastname: Rabe
authors.forename: Eckhart G
authors.initials: EG
authors.lastname: Hahn
authors.forename: Dieter
authors.initials: D
authors.lastname: Schwab
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000378:metabolism; D004750:Enteral Nutrition; D005260:Female; D005773:Gastroscopy / Q000401:mortality*; D005774:Gastrostomy / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012307:Risk Factors