Percutaneous endoscopic gastrostomy (PEG) is an accepted method of placing a feeding tube to enable enteral feeding in patients with swallowing difficulties.
However, the factors associated with complications and death after percutaneous endoscopic gastrostomy have not been studied in detail
Dr Simon Johnston and colleagues from the United Kingdom described the largest audit of deaths after percutaneous endoscopic gastrostomy tube insertion.
|97% of the identified patients had coexistent neurologic disease|
The research team determined the factors associated with death after percutaneous endoscopic gastrostomy tube insertion.
The team identified deaths occurring within 30 days after percutaneous endoscopic gastrostomy tube insertion between 2002 and 2003.
The team sent a questionnaire to the consultant endoscopist for completion.
The team identified a total of 719 patients who died within 30 days after percutaneous endoscopic gastrostomy insertion.
The researchers noted that 97% of the identified patients had coexistent neurologic disease.
Percutaneous endoscopic gastrostomy tubes were inserted by specialized GI physicians in 73% of patients.
The research team observed that 10% of patients required reversal agents after sedation.
After percutaneous endoscopic gastrostomy tube insertion, 43% of patients died within 1 week.
Death was due to cardiovascular disease, respiratory disease, central nervous system disease, renal disease, and hepatic failure.
In 19% of cases, the National Confidential Enquiry into Patient Outcome and Death expert panel regarded the procedure as futile.
Dr Johnston's team concluded, "Mortality and morbidity rates after percutaneous endoscopic gastrostomy tube insertion are not insignificant."
"Selection of patients is paramount to good patient outcomes."
"Multidisciplinary team assessment should be performed on all patients being referred for percutaneous endoscopic gastrostomy tube insertion."