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

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 tertiary-level hospital. We review...

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Autores principales: Lima, Diego L., Miranda, Luiz Eduardo C., da Penha, Marcel Rolland Ciro, Lima, Raquel N. C. L., dos Santos, Dalmir Cavalcanti, Eufrânio, Matheus Stillner, Miranda, Ana Clara G., Pereira, Leila Maria Moreira Beltrão
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372986/
https://www.ncbi.nlm.nih.gov/pubmed/34456551
http://dx.doi.org/10.4293/JSLS.2021.00040
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author Lima, Diego L.
Miranda, Luiz Eduardo C.
da Penha, Marcel Rolland Ciro
Lima, Raquel N. C. L.
dos Santos, Dalmir Cavalcanti
Eufrânio, Matheus Stillner
Miranda, Ana Clara G.
Pereira, Leila Maria Moreira Beltrão
author_facet Lima, Diego L.
Miranda, Luiz Eduardo C.
da Penha, Marcel Rolland Ciro
Lima, Raquel N. C. L.
dos Santos, Dalmir Cavalcanti
Eufrânio, Matheus Stillner
Miranda, Ana Clara G.
Pereira, Leila Maria Moreira Beltrão
author_sort Lima, Diego L.
collection PubMed
description 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 tertiary-level hospital. We reviewed the medical records of 277 patients with PEG placement. The data were analyzed 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 ± 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 multivariate 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 indication for PEG.
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spelling pubmed-83729862021-08-26 Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy Lima, Diego L. Miranda, Luiz Eduardo C. da Penha, Marcel Rolland Ciro Lima, Raquel N. C. L. dos Santos, Dalmir Cavalcanti Eufrânio, Matheus Stillner Miranda, Ana Clara G. Pereira, Leila Maria Moreira Beltrão JSLS Research Article 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 tertiary-level hospital. We reviewed the medical records of 277 patients with PEG placement. The data were analyzed 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 ± 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 multivariate 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 indication for PEG. Society of Laparoendoscopic Surgeons 2021 /pmc/articles/PMC8372986/ /pubmed/34456551 http://dx.doi.org/10.4293/JSLS.2021.00040 Text en © 2021 by SLS, Society of Laparoscopic & Robotic Surgeons. https://creativecommons.org/licenses/by-nc-nd/3.0/us/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/ (https://creativecommons.org/licenses/by-nc-nd/3.0/us/) ), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Research Article
Lima, Diego L.
Miranda, Luiz Eduardo C.
da Penha, Marcel Rolland Ciro
Lima, Raquel N. C. L.
dos Santos, Dalmir Cavalcanti
Eufrânio, Matheus Stillner
Miranda, Ana Clara G.
Pereira, Leila Maria Moreira Beltrão
Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy
title Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy
title_full Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy
title_fullStr Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy
title_full_unstemmed Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy
title_short Factors Associated with 30-Day Mortality in Patients after Percutaneous Endoscopic Gastrostomy
title_sort factors associated with 30-day mortality in patients after percutaneous endoscopic gastrostomy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372986/
https://www.ncbi.nlm.nih.gov/pubmed/34456551
http://dx.doi.org/10.4293/JSLS.2021.00040
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