It is important to carefully select patients who undergo endoscopic procedures, to optimize health care. Percutaneous endoscopic gastrostomy (PEG) is a frequently performed invasive endoscopic procedure that has been associated with high short-term mortality.
Dr Gaurav Arora and colleagues from Texas, USA used a national database to determine the incidence of, and factors associated with, in-hospital mortality among patients undergoing PEG.
The researchers conducted a nested, case-control, retrospective study using the US Nationwide Inpatient Sample (NIS) to analyze data from all hospitalizations in 2006 with an International Classification of Diseases, 9th revision, procedure code for PEG.
Bivariate and multivariate logistic regression analyses were performed using demographic and clinical variables to identify predictors of in-hospital mortality after the procedure.
A separate analysis using a propensity score matching technique was conducted to compare mortality with a control cohort.
|Women had a lower risk of death|
|Clinical Gastroenterology & Hepatology|
The researchers validated results in an independent analysis of 2007 NIS data.
In-hospital mortality was 11% among 181,196 patients who underwent PEG in 2006.
Odds of death increased with age, congestive heart failure, renal failure, chronic pulmonary disease, coagulopathy, pulmonary circulation disorders, metastatic cancer, and liver disease.
The research team found that indication for PEG was associated strongly with mortality.
The team observed that women and patients with diabetes mellitus or paralysis had a lower risk of death.
The researchers found that PEG was associated with slightly higher odds of in-hospital mortality compared with patients who did not undergo PEG.
Qualitatively and quantitatively similar results were obtained when 2007 NIS data were analyzed.
Dr Arora's team comments, "The mortality rate is almost 11% among hospital inpatients after PEG."
"We have identified factors that increase and decrease the risk of death after PEG."
"These factors could improve patient selection for those most likely to benefit from this procedure."