The use of percutaneous endoscopic gastrostomy (PEG) in 161 consecutive elderly patients.

Over the period 1 April 1990 to 31 December 1992, a total of 179 PEG procedures were performed on 161 elderly patients, mean age 79 years (range 53-99). In most (141) patients, the indication was neurological dysphagia (usually stroke), but in 20 the tube was inserted to attain adequate nutritional support. Thirty-day fatality was 20% overall, but in those who underwent PEG only for nutritional support, survival was poor--only 20% at 30 days. Almost all deaths were a result of progression of the original illness. Only one procedure-related death occurred. Fifty-six complicating episodes occurred in 20 (12%) patients, the majority being minor. The commonest adverse event was PEG site infection. PEG is a useful and in general well tolerated procedure in geriatric practice, but careful patient selection is essential; in particular its use as a nutritional adjunct in frail patients needs careful evaluation.