Al-Abboodi Yasir, Ridha Ali, Fasullo Matthew, Naguib Tarek H
Internal Medicine Department, Saint Davis Round Rock Medical Centre, Round Rock, TX, USA.
Internal Medicine Department, University of Arkansas for Medical Science, Little Rock, AR, USA.
Clin Exp Gastroenterol. 2017 Sep 1;10:211-214. doi: 10.2147/CEG.S142644. eCollection 2017.
This study examined the safety of placing percutaneous endoscopic gastrostomy (PEG) tube in people with liver cirrhosis. The target population was further subdivided into people with ascites (case group) and people without ascites (control). We compare the morbidity and the mortality difference of PEG placement in cirrhotic patients with ascites vs cirrhotic patients without ascites. We then examined multiple factors including sex, race, chronic illness including hypertension, congestive heart failure, and others and their influence on the inpatient mortality of all cirrhotic patients who had PEG placement. A total of 38,175 inpatient PEG tube placements were identified. Only 583 patients out of 38,175 had a history of cirrhosis. One hundred seven had ascites and the rest did not. Mean age of the patients was 61.14 years. Patient demography included (65.2%) male and the rest were female, 359 were white (64.4%), 90 black (14.8%), 84 Hispanic (13.7%), 23 Asians (3.3%), 7 Native Americans (0.4%), and 20 others (3.5%). Complications from PEG procedure in cirrhosis with ascites vs non-ascites included bleeding of 4 (0.8%) vs 2 (1.9%) (=0.35), surgical site infection 2 (0.4%) vs 1 (0.9%) (=0.51), and urinary tract infection 105 (22.1%) vs 34 (23.8%) (=0.34), respectively. There was no colonic injury in either group. The total inpatient mortality was 75 out of the 583. Fifty-six (11.8%) were in the ascites group and 19 (17.8%) in the non-ascites group (=0.097). Factors including ascites, postsurgical bleeding, and surgical site infection did not have influence on the inpatient mortality and there were no statistical differences between the two groups.
本研究调查了在肝硬化患者中放置经皮内镜下胃造口术（PEG）管的安全性。目标人群进一步细分为有腹水的患者（病例组）和无腹水的患者（对照组）。我们比较了有腹水的肝硬化患者与无腹水的肝硬化患者进行PEG置管后的发病率和死亡率差异。然后，我们研究了多个因素，包括性别、种族、慢性病（如高血压、充血性心力衰竭等）及其对所有接受PEG置管的肝硬化患者住院死亡率的影响。共确定了38175例住院患者进行PEG管置入。在38175例患者中，只有583例有肝硬化病史。其中107例有腹水，其余无腹水。患者的平均年龄为61.14岁。患者人口统计学特征包括男性占（65.2%），其余为女性；359例为白人（64.4%），90例为黑人（14.8%），84例为西班牙裔（13.7%），23例为亚洲人（3.3%），7例为美洲原住民（0.4%），20例为其他种族（3.5%）。有腹水的肝硬化患者与无腹水的肝硬化患者PEG手术的并发症包括出血，分别为4例（0.8%）和2例（1.9%）（P = 0.35）；手术部位感染，分别为2例（0.4%）和1例（0.9%）（P = 0.51）；尿路感染，分别为105例（22.1%）和34例（23.8%）（P = 0.34）。两组均无结肠损伤。583例患者中总住院死亡率为75例。腹水组56例（11.8%），非腹水组19例（17.8%）（P = 0.097）。腹水、术后出血和手术部位感染等因素对住院死亡率无影响，两组之间无统计学差异。
