Literature DB >> 20976846

Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan.

Yutaka Suzuki1, Seryna Tamez, Akihiko Murakami, Akihiko Taira, Akihiro Mizuhara, Akira Horiuchi, Chie Mihara, Eiji Ako, Hirohito Muramatsu, Hitoshi Okano, Hitoshi Suenaga, Kazuaki Jomoto, Junya Kobayashi, Katsunari Takifuji, Kazuhiro Akiyama, Koh Tahara, Koji Onishi, Makoto Shimazaki, Masami Matsumoto, Masashi Ijima, Masato Murakami, Masato Nakahori, Michiaki Kudo, Michio Maruyama, Mikako Takahashi, Naohiro Washizawa, Shigeru Onozawa, Satoshi Goshi, Satoyoshi Yamashita, Shigeki Ono, Shin Imazato, Shinji Nishiwaki, Shuichirou Kitahara, Takao Endo, Takao Iiri, Takeshi Nagahama, Takuto Hikichi, Tatsuya Mikami, Tetsuo Yamamoto, Tetsushi Ogawa, Tomoko Ogawa, Tomoyuki Ohta, Toshifumi Matsumoto, Toshiroh Kura, Tsutomu Kikuchi, Tsuyoshi Iwase, Tsuyotoshi Tsuji, Yukio Nishiguchi, Mitsuyoshi Urashima.   

Abstract

AIM: To examine the long term survival of geriatric patients treated with percutaneous endoscopic gastrostomy (PEG) in Japan.
METHODS: We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient's characteristics at PEG using log-rank tests and Cox proportional hazard models.
RESULTS: Nine hundred and thirty one patients were followed up for a median of 468 d. A total of 502 deaths were observed (mortality 53%). However, 99%, 95%, 88%, 75% and 66% of 931 patients survived more than 7, 30, 60 d, a half year and one year, respectively. In addition, 50% and 25% of the patients survived 753 and 1647 d, respectively. Eight deaths were considered as PEG-related, and were associated with lower serum albumin levels (P = 0.002). On the other hand, among 28 surviving patients (6.5%), PEG was removed. In a multivariate hazard model, older age [hazard ratio (HR), 1.02; 95% confidence interval (CI), 1.00-1.03; P = 0.009], higher C-reactive protein (HR, 1.04; 95% CI: 1.01-1.07; P = 0.005), and higher blood urea nitrogen (HR, 1.01; 95% CI: 1.00-1.02; P = 0.003) were significant poor prognostic factors, whereas higher albumin (HR, 0.67; 95% CI: 0.52-0.85; P = 0.001), female gender (HR, 0.60; 95% CI: 0.48-0.75; P < 0.001) and no previous history of ischemic heart disease (HR, 0.69; 95% CI: 0.54-0.88, P = 0.003) were markedly better prognostic factors.
CONCLUSION: These results suggest that more than half of geriatric patients with PEG may survive longer than 2 years. The analysis elucidated prognostic factors.

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Year:  2010        PMID: 20976846      PMCID: PMC2965286          DOI: 10.3748/wjg.v16.i40.5084

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


  25 in total

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  21 in total

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