Long-term outcome after placement of a percutaneous endoscopic gastrostomy tube

• Published in: Geriatrics & gerontology international Vol. 8; no. 1; pp. 19 - 23
• Main Authors: Tokunaga, Takanari, Kubo, Tadahiko, Ryan, Suhen, Tomizawa, Muneo, Yoshida, Shin-ichi, Takagi, Koutarou, Furui, Kumiko, Gotoh, Toshio
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.03.2008; Blackwell Publishing Ltd
• Subjects: Abdominal surgery; Adult; Aged; Aged, 80 and over; Clinical outcomes; complications; Enteral Nutrition - methods; Enteral Nutrition - statistics & numerical data; Female; Follow-Up Studies; gastrostomy; Gastrostomy - adverse effects; Gastrostomy - methods; Gastrostomy - mortality; Geriatrics; Humans; hypoalbuminemia; Kaplan-Meier Estimate; Male; Medical prognosis; Middle Aged; Mortality; Parenteral nutrition; pneumonia; Pneumonia, Aspiration; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk Factors; Serum Albumin - analysis; Survival; Treatment Outcome
• ISSN: 1444-1586; 1447-0594
• DOI: 10.1111/j.1447-0594.2008.00442.x

Aim:  To evaluate long‐term survival and prognostic factors in patients who have undergone placement of a percutaneous endoscopic gastrostomy tube. Methods:  A retrospective analysis of all patients without malignancy who underwent percutaneous endoscopic gastrostomy at Hanyu General Hospital during the period January 2001–December 2005. Results:  A total of 198 patients (100 men, 98 women) were assessed. Median age was 78 years (range, 25–97 years). The primary diagnosis was a cerebrovascular disorder in 149 (75.3%) of the patients. Prior to placement, 120 (60.6%) had suffered pneumonia. Survival was 87.4% at 1 month, 67.8% at 3 months, 52.6% at 6 months, 38.1% at 1 year, 27.8% at 2 years and 22.3% at 3 years. Pneumonia was the most common cause of death during the follow‐up period (91 of 140 patients, 65.0%). Cox's proportional hazards model showed independent predictors of mortality to be a low serum albumin concentration (≤2.9 g/dL) and history of pneumonia before the procedure. Conclusions:  Mortality of patients who underwent percutaneous endoscopic gastrostomy appears to be high. In particular, the long‐term prognosis was poor for patients with hypoalbuminemia, and this procedure is probably not preferred for patients with recurrent aspiration pneumonia.