Sobani Zain A, Tin Kevin, Guttmann Steven, Abbasi Anna A, Mayer Ira, Tsirlin Yuriy
Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
Division of Gastroenterology, Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
Clin Endosc. 2018 Jan;51(1):56-60. doi: 10.5946/ce.2017.059. Epub 2017 Jul 21.
BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure; however, no study has evaluated the safety of PEG tube placement in patients over the age of 100 years.
We conducted a retrospective review of patient records for patients who underwent PEG tube placement. Thirty patients aged 100 years and older were identified and a random sample of 275 patients was selected for comparison.
The mean age of the patients was 80.6±16.2 years. No procedure-related deaths or major complications were identified; the overall inpatient mortality rate was 7.6%. Minor complications were noted in 4% (=12) of the patients. Centenarian patients were predominantly female (80% [=24] vs. 54% [=147], =0.006), with a mean age of 100.5±0.9 years. There was no significant difference in procedural success rates (93.3% vs. 97.4%, =0.222) or inpatient mortality (6.7% [=2] vs. 7.7% [=21], =1.000) between the two groups. However, a higher minor complication rate was noted in the older patients (13.3% [=4] vs. 2.9% [=8], =0.022).
Success rates, major complications and inpatient mortality associated with PEG tubes in patients aged over 100 years are comparable to those observed in relatively younger patients at our center; however minor complication rates are relatively higher. These findings lead us to believe that PEG tubes may be safely attempted in carefully selected patients in this subset of the population.
背景/目的:经皮内镜下胃造口术(PEG)是一种相对安全的操作;然而,尚无研究评估100岁以上患者放置PEG管的安全性。
我们对接受PEG管放置的患者的病历进行了回顾性研究。确定了30例年龄在100岁及以上的患者,并随机抽取275例患者作为对照。
患者的平均年龄为80.6±16.2岁。未发现与操作相关的死亡或重大并发症;总体住院死亡率为7.6%。4%(=12)的患者出现了轻微并发症。百岁老人患者以女性为主(80%[=24]对54%[=147],P=0.006),平均年龄为100.5±0.9岁。两组之间的操作成功率(93.3%对97.4%,P=0.222)或住院死亡率(6.7%[=2]对7.7%[=21],P=1.000)没有显著差异。然而,老年患者的轻微并发症发生率较高(13.3%[=4]对2.9%[=8],P=0.022)。
100岁以上患者使用PEG管的成功率、重大并发症和住院死亡率与我们中心相对年轻患者的观察结果相当;然而,轻微并发症发生率相对较高。这些发现使我们相信,在这部分人群中,经过精心挑选的患者可以安全地尝试使用PEG管。