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] [10.1016/j.dld.2019.03.024]

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

A. Anderloni
;
V. Saladino;M. Devani;C. Ciscato;V. Casini;C. Tomba;G. Maconi
Writing – Review & Editing
;
2019

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
apr-2019
Article (author)
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S1590865819305304-main.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 433.76 kB
Formato Adobe PDF
433.76 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/643307
Citazioni
  • ???jsp.display-item.citation.pmc??? 11
  • Scopus 34
  • ???jsp.display-item.citation.isi??? 30
social impact