Friedenberg F, Jensen G, Gujral N, Braitman L E, Levine G M
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
JPEN J Parenter Enteral Nutr. 1997 Mar-Apr;21(2):72-4. doi: 10.1177/014860719702100272.
Percutaneous endoscopic gastrostomy (PEG) tubes have been used since 1980 in patients who require prolonged enteral feeding.
To identify factors associated with poor survival (defined as survival < 30 days) post-PEG.
We assessed a cohort of 64 patients consecutively referred for a percutaneous endoscopic gastrostomy tube in a single, tertiary care hospital. Prior to PEG tube placement, we evaluated relevant clinical variables in each patient to determine their effect on 30-day mortality.
Of the cohort, 43 of 64 (67.2%) survived at least 30 days after tube placement. One death was attributable to tube placement. Bivariate analyses showed that 30-day survival correlated directly with serum albumin (r = .253; p = .049) and inversely with creatinine (r = -0.255; p = .042). Using multivariable logistic regression analysis, only albumin was identified as an independent predictor of 30-day survival (p = .044). Eighty-three percent of patients with a serum albumin > or = 3.0 g/dL survived 30 days compared with 58% with an albumin < 3.0, a difference of 25% (95% CI, -2% to 54%; p = .07).
In conclusion, serum albumin appears to be a predictor of early survival in individuals undergoing percutaneous endoscopic gastrostomy tube placement.
自1980年以来，经皮内镜下胃造口术（PEG）管已用于需要长期肠内喂养的患者。
确定与PEG术后生存不良（定义为生存期<30天）相关的因素。
我们评估了一家三级护理医院中连续接受经皮内镜下胃造口管治疗的64例患者队列。在放置PEG管之前，我们评估了每位患者的相关临床变量，以确定它们对30天死亡率的影响。
在该队列中，64例患者中有43例（67.2%）在置管后至少存活了30天。1例死亡归因于置管。双变量分析显示，30天生存率与血清白蛋白直接相关（r = 0.253；p = 0.049），与肌酐呈负相关（r = -0.255；p = 0.042）。使用多变量逻辑回归分析，仅白蛋白被确定为30天生存的独立预测因素（p = 0.044）。血清白蛋白≥3.0 g/dL的患者中有83%存活了30天，而白蛋白<3.0 g/dL的患者中这一比例为58%，相差25%（95%CI，-2%至54%；p = 0.07）。
总之，血清白蛋白似乎是接受经皮内镜下胃造口管置入术患者早期生存的一个预测指标。
