Department of Surgery, Sunderby Hospital, Kirurgkliniken, Sunderby sjukhus, Sjukhusvägen 10, 954 42, Södra Sunderbyn, Sweden.
Department of Surgical and Preoperative Sciences, Surgery, Sunderby Research Unit, Umeå University, Umeå, Sweden.
BMC Gastroenterol. 2022 Jul 28;22(1):361. doi: 10.1186/s12876-022-02429-0.
Percutaneous endoscopic gastrostomy (PEG) is the method of choice for patients in need of long-term nutritional support or gastric decompression. Although it is considered safe, complications and relatively high mortality rates have been reported. We aimed to identify risk factors for complications and mortality after PEG in routine healthcare.
This retrospective study included all adult patients who received a PEG between 2013 and 2019 in Region Norrbotten, Sweden.
389 patients were included. The median age was 72 years, 176 (45%) were women and 281 (72%) patients received their PEG due to neurological disease. All-cause mortality was 15% at 30 days and 28% at 90 days. Malignancy as the indication for PEG was associated with increased mortality at 90 days (OR 4.41, 95% CI 2.20-8.88). Other factors significantly associated with increased mortality were older age, female sex, diabetes mellitus, heart failure, lower body mass index and higher C-reactive protein levels. Minor and major complications within 30 days occurred in 11% and 15% of the patients, respectively. Diabetes increased the risk of minor complications (OR 2.61, 95% CI 1.04-6.55), while those aged 75 + years were at an increased risk of major complications, compared to those younger than 65 years (OR 2.23, 95% CI 1.02-4.85).
The increased risk of death among women and patients with malignancy indicate that these patients could benefit from earlier referral for PEG. Additionally, we found that age, diabetes, heart failure, C-reactive protein and body mass index all impact the risk of adverse outcomes.
经皮内镜下胃造口术（PEG）是需要长期营养支持或胃减压的患者的首选方法。尽管它被认为是安全的，但已经报道了并发症和相对较高的死亡率。我们旨在确定常规医疗保健中 PEG 后并发症和死亡率的危险因素。
这项回顾性研究包括 2013 年至 2019 年期间在瑞典诺尔兰地区接受 PEG 的所有成年患者。
共纳入 389 例患者。中位年龄为 72 岁，176 例（45%）为女性，281 例（72%）患者因神经疾病接受 PEG。30 天和 90 天的全因死亡率分别为 15%和 28%。PEG 的适应证为恶性肿瘤与 90 天死亡率增加相关（OR 4.41，95%CI 2.20-8.88）。其他与死亡率增加显著相关的因素包括年龄较大、女性、糖尿病、心力衰竭、较低的体重指数和较高的 C 反应蛋白水平。30 天内发生的轻微和主要并发症分别占 11%和 15%。糖尿病增加了轻微并发症的风险（OR 2.61，95%CI 1.04-6.55），而 75 岁以上的患者与 65 岁以下的患者相比，发生严重并发症的风险更高（OR 2.23，95%CI 1.02-4.85）。
女性和恶性肿瘤患者的死亡风险增加表明这些患者可能受益于更早地进行 PEG 转诊。此外，我们发现年龄、糖尿病、心力衰竭、C 反应蛋白和体重指数都影响不良结果的风险。
