Ahmad Muhammad Bilal, Ansar Farrukh, Shakoor Kainaat, Adnan Muhammad, Naqi Syed Ali, Tahir Zainab, Rauf Mohammad S, Bin Shafaat Chaudhary Umair, Alamgir Asad, Aslam Nabiha
Medicine, Quaid-e-Azam International Hospital, Islamabad, PAK.
Surgery, Quaid-e-Azam International Hospital, Islamabad, PAK.
Cureus. 2023 Aug 16;15(8):e43566. doi: 10.7759/cureus.43566. eCollection 2023 Aug.
Percutaneous endoscopic gastrostomy (PEG) tube insertion is a widely utilized enteral access technique offering long-term nutritional support for patients unable to tolerate oral intake. While the PEG tube provides numerous advantages, adherence to evidence-based guidelines is crucial to minimize complications. This study aims to evaluate adherence to PEG tube insertion guidelines and analyze associated complication rates in a tertiary care setting.
A retrospective clinical audit was conducted at Quaid-e-Azam International Hospital, Islamabad. Data were collected over three years from patients undergoing PEG tube insertion by a single consultant gastrointestinal surgeon. Adherence to guidelines was evaluated using a 10-item checklist developed based on European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Complication rates and patient characteristics were analyzed.
The study included 70 participants (mean age = 72.21 ± 13.17). The PEG tube insertion rate was 100%. The mean checklist score was 8.34 ± 1.2. Laboratory investigations were performed for 98.6% of patients. 91.4% of patients had a life expectancy exceeding 30 days. 60% of patients received an anticoagulation hold. Prophylactic antibiotics were administered to 90% of patients. Psychological counseling and dietician consultation were offered to 38.6% and 64.2% of patients, respectively. Caregivers received specialized training in 98.5% of cases. 12.8% of patients experienced early complications post-procedure, and 14.2% experienced late complications. PEG tube removal occurred in 27% of patients, with only one patient experiencing complications after removal.
Adherence to PEG tube insertion guidelines was observed in various aspects of patient care, resulting in a low incidence of complications. Comprehensive auditing and guideline adherence are essential to ensure optimal patient safety and procedural outcomes.
经皮内镜下胃造口术（PEG）置管是一种广泛应用的肠内通路技术，为无法耐受经口摄入的患者提供长期营养支持。虽然PEG管有诸多优点，但遵循循证指南对于将并发症降至最低至关重要。本研究旨在评估在三级医疗环境中对PEG管置管指南的遵循情况，并分析相关并发症发生率。
在伊斯兰堡的奎德-阿扎姆国际医院进行了一项回顾性临床审计。收集了由一位胃肠外科顾问医生为患者进行PEG管置管的三年期间的数据。使用基于欧洲胃肠内镜学会（ESGE）指南制定的10项检查表评估对指南的遵循情况。分析了并发症发生率和患者特征。
该研究纳入了70名参与者（平均年龄 = 72.21 ± 13.17）。PEG管置管率为100%。检查表平均得分为8.34 ± 1.2。98.6%的患者进行了实验室检查。91.4%的患者预期寿命超过30天。60%的患者停用了抗凝药。90%的患者使用了预防性抗生素。分别为38.6%和64.2%的患者提供了心理咨询和营养师咨询。98.5%的病例中护理人员接受了专门培训。12.8%的患者术后出现早期并发症，14.2%的患者出现晚期并发症。27%的患者拔除了PEG管，拔除后只有1名患者出现并发症。
在患者护理的各个方面均观察到对PEG管置管指南的遵循，并发症发生率较低。全面审计和遵循指南对于确保最佳患者安全和手术效果至关重要。
