Proton pump inhibitor use before percutaneous endoscopic gastrostomy is associated with adverse outcomes.
OBJECTIVE
Knowledge of the risk factors associated with adverse outcomes after percutaneous endoscopic gastrostomy (PEG) may be helpful for developing PEG recommendations. The purpose of this study was to identify the clinical risk factors associated with adverse clinical outcomes after PEG, especially regarding the use of proton pump inhibitors (PPIs).


METHODS
We retrospectively reviewed the data from PEG patients at seven university hospitals between June 2006 and January 2012. All patients were followed up through February 2012 after PEG, and the clinical risk factors for adverse clinical outcomes after PEG were analyzed.


RESULTS
Data from 1,021 PEG patients were analyzed. PPI users were more frequently included in the complication group than the noncomplication group (p=0.040). PEG-related complications (p=0.040) and mortality (p=0.003) were more frequent in the PPI group than in the control group. In the subgroup analysis of complicated PEG cases, infectious complications were more frequently found in the PPI group than in the control group (35.8% vs 27.8%). After adjustment for multiple possible confounding factors, PPI users (odds ratio, 1.531; 95% confidence interval, 1.017 to 2.305) and diabetic patients had increased mortality after PEG.


CONCLUSIONS
PPI use may be associated with adverse outcomes in patients with PEG; however, further prospective studies investigating this issue are warranted.
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Jong Pil
JP
Im
Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Jae Myung
JM
Cha
Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Ji Won
JW
Kim
Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Seong Eun
SE
Kim
Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Dong Yup
DY
Ryu
Department of Internal Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
Eun Young
EY
Kim
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Eun Ran
ER
Kim
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Dong Kyung
DK
Chang
D000368:Aged; D016022:Case-Control Studies; D004750:Enteral Nutrition / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects* / Q000401:mortality; D005774:Gastrostomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D008297:Male; D011379:Prognosis; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors
D054328:Proton Pump Inhibitors
Complication; Mortality; Percutaneous endoscopic gastrostomy; Proton pump inhibitors; Risk factors