Background: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. Aim: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. Methods: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. Results: 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0–1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77−0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. Conclusions: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.

Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study / A. Anderloni, M. Di Leo, F. Barzaghi, R. Semeraro, G. Meucci, R. Marino, L. Amato, M. Frigerio, V. Saladino, A. Toldi, G. Manfredi, A. Redaelli, M. Feliziani, G. De Roberto, F. Boni, G. Scacchi, D. Mosca, M. Devani, M. Arena, M. Massidda, P. Zanoni, C. Ciscato, V. Casini, P. Beretta, E. Forti, R. Salerno, V. Caramia, M. Bianchetti, C. Tomba, A. Evangelista, A. Repici, M. Soncini, G. Maconi, G. Manes, R. Gullotta. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - (2019 Apr). [Epub ahead of print]

Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study

Anderloni, Andrea;Saladino, Valeria;DEVANI, MASSIMO;Ciscato, Camilla;Casini, Valentina;Tomba, Carolina;Maconi, Giovanni;
2019-04

Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. Aim: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. Methods: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. Results: 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0–1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77−0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. Conclusions: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.
Complications; Mortality; PEG; Risk factors; Short-term outcome; Hepatology; Gastroenterology
Settore MED/12 - Gastroenterologia
DIGESTIVE AND LIVER DISEASE
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/643307
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