Shangab Maha Osman Mohamed, Shaikh Niaz Ahmed
Department of Internal Medicine, Rashid Hospital, Dubai, UAE.
Ann Gastroenterol. 2019 Sep-Oct;32(5):469-475. doi: 10.20524/aog.2019.0409. Epub 2019 Jul 25.
Percutaneous endoscopic gastrostomy (PEG) is a popular method for long-term enteral feeding. Our aim was to determine potential risk factors for adverse events related to PEG, as well as consequent prolonged hospitalization.
Data were retrospectively collected from the admission records of a tertiary center between July 2015 and June 2018. Possible predictors of the 3 following outcomes were evaluated: minor PEG-related adverse events, major PEG-related adverse events, and length of hospital stay. Data were tested for correlation using the Spearman coefficient and for association using Kruskal-Wallis tests for significance.
A total of 362 admissions involving 146 patients were included in the study. Of the admissions, 221 (61.0%) had only minor adverse events, 100 (27.6%) had only major adverse events, and 41 (11.3%) had both. Eighty (22.1%) had PEG-site infection and 128 (35%) had aspiration pneumonia. Serum albumin levels at presentation were negatively correlated with the length of hospitalization (P<0.001), which also differed between patients presenting with major and minor adverse events (P<0.001 and P=0.026). The Charlson comorbidity index was positively correlated with the duration of hospitalization (P<0.001). Higher index scores were found more among patients presenting with aspiration pneumonia (P=0.004) and lower scores were found among patients presenting with PEG site infection and inadvertent PEG removal compared with those presenting with a major complication (P<0.001).
The patient's general medical condition and nutritional status are the greatest risk predictors for developing adverse events related to their PEG feeding, as well as a consequent extended hospital stay.
经皮内镜下胃造口术（PEG）是一种常用的长期肠内营养支持方法。我们的目的是确定与PEG相关的不良事件以及随之而来的住院时间延长的潜在风险因素。
回顾性收集2015年7月至2018年6月间某三级中心的入院记录数据。评估以下3种结果的可能预测因素：PEG相关的轻微不良事件、PEG相关的严重不良事件以及住院时间。使用Spearman系数检验数据的相关性，使用Kruskal-Wallis检验评估数据的关联性以确定显著性。
本研究共纳入146例患者的362次入院记录。其中，221次入院（61.0%）仅有轻微不良事件，100次入院（27.6%）仅有严重不良事件，41次入院（11.3%）两者皆有。80例（22.1%）发生PEG部位感染，128例（35%）发生吸入性肺炎。入院时的血清白蛋白水平与住院时间呈负相关（P<0.001），在发生严重和轻微不良事件的患者中也存在差异（P<0.001和P=0.026）。Charlson合并症指数与住院时间呈正相关（P<0.001）。与发生严重并发症的患者相比，吸入性肺炎患者的指数得分更高（P=0.004），而PEG部位感染和意外拔除PEG的患者得分更低（P<0.001）。
患者的总体健康状况和营养状况是发生与PEG喂养相关不良事件以及随之延长住院时间的最大风险预测因素。
