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经皮内镜下胃造口术相关不良事件风险的预测:一项回顾性研究。

Prediction of risk of adverse events related to percutaneous endoscopic gastrostomy: a retrospective study.

作者信息

Shangab Maha Osman Mohamed, Shaikh Niaz Ahmed

机构信息

Department of Internal Medicine, Rashid Hospital, Dubai, UAE.

出版信息

Ann Gastroenterol. 2019 Sep-Oct;32(5):469-475. doi: 10.20524/aog.2019.0409. Epub 2019 Jul 25.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

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本文引用的文献

1
Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study.
Dig Liver Dis. 2019 Oct;51(10):1380-1387. doi: 10.1016/j.dld.2019.03.024. Epub 2019 Apr 20.
3
Risk factors for complications and mortality of percutaneous endoscopic gastrostomy insertion.
BMC Gastroenterol. 2018 Jun 28;18(1):101. doi: 10.1186/s12876-018-0825-8.
4
Percutaneous endoscopic gastrostomy site infections-Incidence and risk factors.
Indian J Gastroenterol. 2018 Mar;37(2):103-107. doi: 10.1007/s12664-018-0822-4. Epub 2018 Feb 23.
5
[Gastrostomy tubes: indications and infectious complications in a tertiary hospital].
Rev Esp Quimioter. 2017 Oct;30(5):334-340. Epub 2017 Aug 14.
7
Severe hypernatremia as a predictor of mortality after percutaneous endoscopic gastrostomy (PEG) placement.
Dig Liver Dis. 2017 Feb;49(2):181-187. doi: 10.1016/j.dld.2016.10.015. Epub 2016 Nov 2.
8
Percutaneous Endoscopic Gastrostomy: Technical Problems, Complications, and Management.
Indian J Surg. 2015 Dec;77(Suppl 3):1159-64. doi: 10.1007/s12262-015-1227-6. Epub 2015 Jan 23.
9
Short-Term Complications of Percutaneous Endoscopic Gastrostomy according to the Type of Technique.
Pediatr Gastroenterol Hepatol Nutr. 2014 Dec;17(4):214-22. doi: 10.5223/pghn.2014.17.4.214. Epub 2014 Dec 31.
10
Percutaneous endoscopic gastrostomy: indications, technique, complications and management.
World J Gastroenterol. 2014 Jun 28;20(24):7739-51. doi: 10.3748/wjg.v20.i24.7739.

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