Oh Dong Jun, Kim Bernice, Lee Jun Kyu, Kang Hyoun Woo, Kim Jae Hak, Lim Yun Jeong, Koh Moon-Soo, Lee Jin Ho
Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University, College of Medicine, Goyang, Korea.
Geriatr Gerontol Int. 2016 Apr;16(4):481-5. doi: 10.1111/ggi.12495. Epub 2015 Apr 23.
Percutaneous endoscopic gastrostomy (PEG) is carried out commonly for patients with dysphagia. Clinicians, however, are often reluctant to carry out PEG in the elderly because of concerns about complications and short life expectancy. The present study aimed to assess the safety of PEG in elderly patients.
The medical records of 116 patients who received PEG from October 2005 to May 2012 were reviewed retrospectively. Among them, 63 patients were aged 65 years and older (the elderly group), and 53 were aged less than 65 years (the younger group).
Baseline characteristics showed no significant difference in both groups, except that pulmonary comorbidities was more common in the elderly group (P = 0.003). Overall, PEG-related complications occurred in 23 (19.8%) patients. Wound infections were the most common (15 patients), and followed by gastrointestinal bleeding, esophageal injury, pneumomediastinum and buried bumper syndrome. Although there was no difference in the overall complications, wound infections were less frequent in the elderly group than in the younger group (4 [6.3%] out of 63 vs 11 [20.8%] out of 53, P = 0.027). There were 17 (14.7%) cases of mortality, with three patients (2.5%) dying within 30 days after the procedure and the causes of deaths were unrelated to PEG. No significant difference in mortality rate was observed between the two groups (13 [20.6%] vs 4 [7.5%], P = 0.065).
PEG can be carried out safely in elderly patients, as procedure-related complications and mortality did not increase compared with those of younger patients.
经皮内镜下胃造口术（PEG）常用于吞咽困难患者。然而，由于担心并发症和预期寿命短，临床医生往往不愿对老年患者实施PEG。本研究旨在评估老年患者PEG的安全性。
回顾性分析2005年10月至2012年5月期间接受PEG的116例患者的病历。其中，63例患者年龄在65岁及以上（老年组），53例患者年龄小于65岁（年轻组）。
基线特征显示两组无显著差异，只是老年组肺部合并症更为常见（P = 0.003）。总体而言，23例（19.8%）患者发生了PEG相关并发症。伤口感染最为常见（15例），其次是胃肠道出血、食管损伤、纵隔气肿和埋藏式胃造口管综合征。虽然总体并发症无差异，但老年组伤口感染的发生率低于年轻组（63例中有4例[6.3%]，53例中有11例[20.8%]，P = 0.027）。有17例（14.7%）死亡病例，3例患者（2.5%）在术后30天内死亡，死亡原因与PEG无关。两组死亡率无显著差异（13例[20.6%]对4例[7.5%]，P = 0.065）。
PEG可在老年患者中安全实施，因为与手术相关的并发症和死亡率与年轻患者相比并未增加。
