Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy

被引:5
作者
Lima, Diego L. [1 ]
Miranda, Luiz Eduardo C. [2 ]
Ciro da Penha, Marcel Rolland [2 ,3 ]
Lima, Raquel N. C. L. [4 ]
dos Santos, Dalmir Cavalcanti [4 ]
Eufranio, Matheus Stillner [5 ]
Miranda, Ana Clara G. [5 ]
Moreira Beltrao Pereira, Leila Maria [6 ]
机构
[1] Montefiore Med Ctr, Dept Surg, 111 E 210th St, Bronx, NY 10467 USA
[2] Oswaldo Cruz Univ Hosp, Dept Surg, Recife, PE, Brazil
[3] Univ Catolica Pernambuco, Recife, PE, Brazil
[4] Pernambuco Hlth Coll, Recife, PE, Brazil
[5] Univ Pernambuco, Oswaldo Cruz Univ Hosp, Recife, PE, Brazil
[6] Univ Pernambuco, Pernambuco Inst Liver, Oswaldo Cruz Univ Hosp, Recife, PE, Brazil
关键词
Deglutition disorders; Malnutrition; Enteral; nutrition; Critical illness; PEG tube; TERTIARY CARE CENTER; PREDICTIVE FACTORS; RISK-FACTORS; TUBE INSERTION; ALBUMIN LEVEL; OLDER-ADULTS; SURVIVAL; OUTCOMES; COMPLICATIONS; MULTICENTER;
D O I
10.4293/JSLS.2021.00040
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Percutaneous endoscopic gastrostomy (PEG) is the main accepted method for long-term tube feeding. The aim of this study is to investigate the risk factors associated with early mortality after PEG. Methods: It is a retrospective survival analysis in a terti-ary-level hospital. We reviewed the medical records of 277 patients with PEG placement. The data were ana-lyzed by the Kaplan-Meier method. Multivariable Cox proportional regression models were also built to test the effects of PEG on mortality. Results: A total of 277 patients who submitted to PEG were studied. One-hundred and sixty (58%) were female, mean age of 73.3 6 15.7 years. Ninety-three patients (33.6%) had diabetes mellitus and 165 (59.6%) had blood hypertension. The indications for PEG placement were chronic neurologic dysphagia in 247 (89.5%) patients and tumors and other diseases in 29 (10.5%). The 30 days proportional mortality probability rate was 13%. In a mul-tivariate Cox proportional regression model, preoperative ICU hospitalization (HR 1.79, 95% CI 1.36-2.36, P = 0.000) and hemoglobin (HR 0.91, 95% CI 0.85-0.98, P = 0.015) were predictors of early mortality. Conclusion: In patients who had underwent PEG tube insertion for long-term nutrition, anemia and previous ICU admission were predictors of mortality at four weeks. These factors may guide physicians to discourage the in-dication for PEG.
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