Xin Ryan, Sanossian Cassandra, Fazzari Melissa, Mui Brandon, Hossain Marouf, Katz Jennifer
Department of Gastroenterology, Montefiore Medical Center, Bronx, NY, USA.
Division of Gastroenterology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Clin Endosc. 2025 May;58(3):418-424. doi: 10.5946/ce.2024.118. Epub 2025 Jan 23.
BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) tube placement is a common procedure used to initiate enteral feeding. To our knowledge, there are no previous studies that analyze predictors of PEG failure. This study aims to identify risk factors for failure of inpatient PEG placement.
A retrospective chart review was conducted of inpatients in the Montefiore Health System who were scheduled to undergo PEG placement from 2016 to 2020 (n=1,138). Patient, endoscopist, and procedural characteristics were summarized using descriptive statistics, both overall and stratified by whether the PEG was successfully placed.
The overall success rate of PEG placement was 89%. The most common indications included stroke (31%), dementia (27%), and ventilator use (24%). Patient characteristics, including body mass index (BMI) (p=0.16) and indication for PEG placement (p=0.06), were not significantly associated with PEG failure. Instead, endoscopist and procedural characteristics were found to be significant, including type of attending (p<0.001), location of case (p=0.02), and category of anesthesia (p<0.001).
PEG placement remains a highly successful procedure. Endoscopist and procedural characteristics, not patient characteristics, were associated with PEG placement success. Notably, patient BMI and indication for PEG placement could not be used to risk stratify candidates for PEG placement.
背景/目的：经皮内镜下胃造口术（PEG）置管是启动肠内营养的常用操作。据我们所知，此前尚无分析PEG失败预测因素的研究。本研究旨在确定住院患者PEG置管失败的危险因素。
对2016年至2020年计划在蒙特菲奥里医疗系统接受PEG置管的住院患者（n = 1138）进行回顾性病历审查。使用描述性统计对患者、内镜医师和操作特征进行总结，整体情况以及按PEG是否成功置管进行分层总结。
PEG置管的总体成功率为89%。最常见的适应证包括中风（31%）、痴呆（27%）和使用呼吸机（24%）。患者特征，包括体重指数（BMI）（p = 0.16）和PEG置管适应证（p = 0.06），与PEG失败无显著相关性。相反，发现内镜医师和操作特征具有显著性，包括主治医师类型（p < 0.001）、病例所在位置（p = 0.02）和麻醉类别（p < 0.001）。
PEG置管仍然是一种高度成功的操作。与PEG置管成功相关的是内镜医师和操作特征，而非患者特征。值得注意的是，患者BMI和PEG置管适应证不能用于对PEG置管候选人进行风险分层。
