Humanitas Research Hospital, Rozzano, Italy.
Humanitas Research Hospital, Rozzano, Italy; Humanitas University, Rozzano, Italy.
Dig Liver Dis. 2019 Oct;51(10):1380-1387. doi: 10.1016/j.dld.2019.03.024. Epub 2019 Apr 20.
Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support.
To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement.
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.
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.
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.
经皮内镜胃造口术（PEG）是最常用于提供营养支持的内镜程序。
前瞻性评估 PEG 插入或更换后的死亡率和并发症发生率。
所有接受 PEG 插入或更换的患者均被纳入研究。收集患者特征、正在进行的治疗、合并症和 PEG 放置/更换指征的详细信息，以及知情同意书的签名。评估早期和晚期（30 天）并发症和死亡率。
在意大利北部伦巴第地区的 25 个中心，共纳入 950 名（47.1%为男性）患者。患者平均年龄为 73 岁。69.5%的患者 ASA 状态为 3 或 4 级。首次 PEG 放置在 594 名患者中进行。并发症和死亡率分别为 4.8%和 5.2%。最常见的并发症是感染（50%），其次是出血（32.1%）、管移位（14.3%）和埋藏式 bumper 综合征（3.6%）。多变量分析显示，年龄（每增加 1 岁，OR 1.08，95%CI，1.0-1.16，p=0.010）和 BMI（每增加 1 个点，OR 0.86，95%CI，0.77-0.96，p=0.014）是与死亡率相关的因素。356 名患者进行了 PEG 更换。30 天死亡率为 1.8%，并发症发生率为 1.7%。
我们的数据证实 PEG 放置是一种安全的程序。死亡率与该程序本身无关，这证实了需要进行仔细的患者选择。
