title: Survival After Percutaneous Endoscopic Gastrostomy in Older Adults With Neurologic Disorders.
abstract: BACKGROUND
  Percutaneous endoscopic gastrostomy (PEG) tube placement is a common procedure performed to provide a route for enteral feeding. We aimed to examine the survival after PEG in older adults with neurologic disease and to demonstrate the factors associated with mortality.
  
  
  METHODS
  We analyzed the data of 500 patients who underwent PEG placement between 2005 and 2015 at a university hospital. The data included age, sex, follow-up duration, comorbidities, medications, indications for PEG, complications, and laboratory results. Related risk factors and mortality rates were analyzed.
  
  
  RESULTS
  Median age was 77 years. Median survival time after PEG placement was 13.9 months. The 30-day, 3-month, 1-year, 2-year, 3-year, and 5-year mortality rates were 11.3%, 28.3%, 46.8%, 56.3 %, 63.0%, and 67.8%, respectively. Stroke was independently correlated with mortality (odds ratio [OR], 2.20; 95% confidence interval [CI], 1.52-3.19; P < .001). Overall survival time after PEG placement was shorter in patients with stroke than without stroke (11.4 vs 27.1 months, P = .014). In multivariate logistic regression analyses, preprocedural neutrophil percentage (OR, 1.10; 95% CI, 1.02-1.17, P = .015) and late complications (OR, 9.2; 95% CI, 1.80-46.90; P = .008) were independent risk factors for mortality in the stroke subgroup. Prophylactic antibiotic usage (OR, 0.07; 95% CI, 0.17-0.29; P < .001) and hyperlipidemia (OR, 0.30; 95% CI, 0.86-1.00; P = .048) were independently and inversely correlated with mortality in stroke patients.
  
  
  CONCLUSIONS
  Stroke patients had higher mortality rates than other neurological indications for PEG. In stroke patients with PEG, neutrophil percentage was independently correlated with mortality, while hyperlipidemia and preprocedural antibiotic usage were independently related with survival.
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kara
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Muhammet Cemal
authors.initials: MC
authors.lastname: Kizilarslanoglu
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Busra
authors.initials: B
authors.lastname: Canbaz
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Gunes
authors.initials: G
authors.lastname: Arik
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Hacer Dogan
authors.initials: HD
authors.lastname: Varan
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Kuyumcu
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Mustafa Kemal
authors.initials: MK
authors.lastname: Kilic
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Sumer
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yesil
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Burcu Balam
authors.initials: BB
authors.lastname: Yavuz
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cankurtaran
authors.affiliation: 2 Hacettepe University Medical School, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Ozturk
authors.affiliation: 2 Hacettepe University Medical School, Department of Internal Medicine, Division of Gastroenterology, Ankara, Turkey.
authors.forename: Taylan
authors.initials: T
authors.lastname: Kav
authors.affiliation: 1 Hacettepe University Medical School, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Halil
mesh_terms: D000368:Aged; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D009422:Nervous System Diseases; D012189:Retrospective Studies; D012307:Risk Factors
keywords: gastrostomy; mortality; older adults; stroke