Andrea Anderloni1, Milena Di Leo2, Franco Barzaghi3, Rossella Semeraro4, Gianmichele Meucci5, Roberta Marino6, Loretta Amato4, Mauro Frigerio7, Valeria Saladino8, Anna Toldi9, Guido Manfredi10, Alessandro Redaelli11, Marcella Feliziani12, Giuseppe De Roberto13, Francesca Boni14, Gianlorenzo Scacchi15, Davide Mosca16, Massimo Devani17, Monica Arena18, Marco Massidda19, Paolo Zanoni20, Camilla Ciscato21, Valentina Casini22, Paolo Beretta21, Edoardo Forti23, Raffaele Salerno24, Vitantonio Caramia25, Mario Bianchetti26, Carolina Tomba27, Andrea Evangelista28, Alessandro Repici2, Marco Soncini27, Giovanni Maconi29, Gianpiero Manes17, Renzo Gullotta30. 1. Humanitas Research Hospital, Rozzano, Italy. Electronic address: andrea.anderloni@humanitas.it. 2. Humanitas Research Hospital, Rozzano, Italy; Humanitas University, Rozzano, Italy. 3. Presidio Ospedaliero di Busto Arsizio, Busto Arsizio, Italy. 4. Humanitas Research Hospital, Rozzano, Italy. 5. Ospedale San Giuseppe, Milan, Italy. 6. ASST Lodi, Lodi, Italy. 7. Azienda Sanitaria Locale della Provincia di Como, Como, Italy. 8. ASST OVEST Milanese, Milan, Italy. 9. Ospedale Valduce, Como, Italy. 10. Ospedale Maggiore ASST Crema, Crema, Italy. 11. ASST-Monza San Gerardo, Monza, Italy. 12. Azienda Ospedaliera Sant'Antonio Abate, Gallarate, Italy. 13. Istituto Europeo di Oncologia, Milan, Italy. 14. ASST Melegnano e Martesana, Ospedale di Vizzolo Predabissi, Milan, Italy. 15. Ospedale Policlinico, Milan, Italy. 16. Azienda Ospedaliera S. Anna, Como, Italy. 17. ASST Rhodense, Ospedali di Rho e Garbagnate M.se, Milan, Italy. 18. Ospedale San Paolo, Milan, Italy. 19. Istituto Clinico Humanitas Gavazzeni, Bergamo, Italy. 20. Casa di cura San Francesco, Bergamo, Italy. 21. ICCS Istituto Clinico Citta' Studi, Milan, Italy. 22. ASST Bergamo EST-Ospedale Bolognini, Bergamo, Italy. 23. Ospedale Niguarda Ca' Grande, Milan, Italy. 24. ASST Fatebenefratelli Sacco, Milan, Italy. 25. Fondazione Salvatore Maugeri, Pavia, Italy. 26. Humanitas Mater Domini, Castellanza, Italy. 27. ASST Santi Paolo e Carlo, Milan, Italy. 28. Unit of Clinical Epidemiology, CPO, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. 29. Gastroenterology Unit, FBF - Sacco University Hospital, Milan, Italy. 30. Clinica San Carlo, Paderno Dugnano, Italy.
Abstract
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. AIM: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. METHODS: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. RESULTS: 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0-1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77-0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. CONCLUSIONS: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. AIM: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. METHODS: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. RESULTS: 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0-1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77-0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. CONCLUSIONS: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.
Authors: Sara Lopes; Vitor Tavares; Paulo Mascarenhas; Marta Lopes; Carolina Cardote; Catarina Godinho; Cátia Oliveira; Carla Adriana Santos; Madalena Oom; José Grillo-Evangelista; Jorge Fonseca Journal: Int J Environ Res Public Health Date: 2022-04-15 Impact factor: 4.614
Authors: Andrew M Veitch; Franco Radaelli; Raza Alikhan; Jean-Marc Dumonceau; Diane Eaton; Jo Jerrome; Will Lester; David Nylander; Mo Thoufeeq; Geoffroy Vanbiervliet; James R Wilkinson; Jeanin E van Hooft Journal: Endoscopy Date: 2021-08-06 Impact factor: 10.093
Authors: Andrew M Veitch; Franco Radaelli; Raza Alikhan; Jean Marc Dumonceau; Diane Eaton; Jo Jerrome; Will Lester; David Nylander; Mo Thoufeeq; Geoffroy Vanbiervliet; James R Wilkinson; Jeanin E Van Hooft Journal: Gut Date: 2021-09 Impact factor: 23.059