title: Complication and mortality rate after percutaneous endoscopic gastrostomy are low and indication-dependent.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy (PEG) is often used for the feeding of patients with malnutrition due to dysphagia, and despite more than 30 years experience, numerous questions on its benefit remain. This was a prospective observational study to assess the safety of PEG.
  
  
  METHODS
  One hundred and nineteen patients mean age 63 years (21-91 years) who were admitted to the Hannover Medical School between November 2010 and March 2012 and had an indication for PEG according to the German guidelines were included. Primary endpoints were the following: reason for indication, date of in-hospital mortality after PEG insertion, death within 3 months after PEG placement, and complications.
  
  
  RESULTS
  Most patients (54.6%) received PEG for dysphagia caused by tumors and second (29.4%) for neurologic diseases with a minor proportion of dementia (3%). About 73% of our patients had no complications at all and only 10% suffered severe effects. We saw only 1 case of aspiration, which did not lead to pneumonia. The 30-day mortality was 10%, and no patient died as a result of the PEG procedure. Significantly more patients with neurologic disorders died within 24 weeks of PEG placement than tumor patients (60% versus 27.7%, respectively, p = 0.002, n = 100).
  
  
  CONCLUSIONS
  It is important to select patients receiving PEG very carefully. The patients' indications, their primary disease, and their capability for mental cooperation are essential. If these aspects are taken into account, PEG is a safe method with few mainly mild complications.
authors.affiliation: Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School , Hannover , Germany.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Schneider
authors.forename: Anika
authors.initials: A
authors.lastname: Schettler
authors.forename: Andrea
authors.initials: A
authors.lastname: Markowski
authors.forename: Birgit
authors.initials: B
authors.lastname: Luettig
authors.forename: Birgit
authors.initials: B
authors.lastname: Kaufmann
authors.forename: Sabine
authors.initials: S
authors.lastname: Klamt
authors.forename: Henrike
authors.initials: H
authors.lastname: Lenzen
authors.forename: Michael
authors.initials: M
authors.lastname: Momma
authors.forename: Claudia
authors.initials: C
authors.lastname: Seipt
authors.forename: Tim
authors.initials: T
authors.lastname: Lankisch
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Negm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies
keywords: artificial feeding; cancer; dysphagia; nutrition; percutaneous endoscopic gastrostomy