Mariana Brito1,2, Ana Laranjo3, Gonçalo Nunes1,2, Cátia Oliveira1, Carla Adriana Santos1, Jorge Fonseca1,2. 1. GENE-Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal. 2. PaMNEC-Grupo de Patologia Médica, Nutrição e Exercício Clínico, CiiEM, Centro de Investigação Interdisciplinar Egas Moniz, 2829-511 Monte da Caparica, Portugal. 3. Gastroenterology Department, Hospital do Espírito Santo de Évora, 7000-811 Évora, Portugal.
Abstract
INTRODUCTION AND AIMS: Patients undergoing percutaneous endoscopic gastrostomy (PEG) may present protein-energy malnutrition, anemia and deficiencies of hematopoietic factors, e.g., iron, folate and vitamin B12. There are no comprehensive studies on anemia or other hematological changes in PEG-patients. Our aim was to evaluate the hematological status of dysphagic patients that had undergone PEG and its association with clinical outcome. METHODS: This research comprises a retrospective study of patients followed by our Artificial Feeding Team, submitted to PEG from 2010 to 2018. Patients were divided into two etiological groups: neurological dysphagia (ND) and head/neck or esophageal disorders (HNE). Laboratory data included serum albumin, hemoglobin, mean corpuscular volume, ferritin, transferrin, iron, vitamin B12 and folate. Survival after PEG was recorded in months, until death or December 2018. RESULTS: We evaluated 472 patients; 250 (53%) presented anemia at the moment of gastrostomy, mostly normocytic (n = 219), with laboratory data suggestive of anemia of chronic disease (ACD). Six patients (1.3%) presented vitamin B12 deficiency and 57 (12.1%) presented folate deficit. No statistically significant difference in hemoglobin was found between the etiological groups (p = 0.230). Folate and vitamin B12 levels were lower in the HNE group (p < 0.01). A positive correlation between hemoglobin and survival was present (p < 0.01, r = 0.289), and hemoglobin levels were lower in the deceased population (p < 0.01). CONCLUSION: Anemia is frequent in PEG-patients, mostly with the features of ACD or multifactorial. It is associated with significant decrease in survival and may be viewed as a marker of severe metabolic distress, signaling poor outcome.
INTRODUCTION AND AIMS: Patients undergoing percutaneous endoscopic gastrostomy (PEG) may present protein-energy malnutrition, anemia and deficiencies of hematopoietic factors, e.g., iron, folate and vitamin B12. There are no comprehensive studies on anemia or other hematological changes in PEG-patients. Our aim was to evaluate the hematological status of dysphagic patients that had undergone PEG and its association with clinical outcome. METHODS: This research comprises a retrospective study of patients followed by our Artificial Feeding Team, submitted to PEG from 2010 to 2018. Patients were divided into two etiological groups: neurological dysphagia (ND) and head/neck or esophageal disorders (HNE). Laboratory data included serum albumin, hemoglobin, mean corpuscular volume, ferritin, transferrin, iron, vitamin B12 and folate. Survival after PEG was recorded in months, until death or December 2018. RESULTS: We evaluated 472 patients; 250 (53%) presented anemia at the moment of gastrostomy, mostly normocytic (n = 219), with laboratory data suggestive of anemia of chronic disease (ACD). Six patients (1.3%) presented vitamin B12deficiency and 57 (12.1%) presented folate deficit. No statistically significant difference in hemoglobin was found between the etiological groups (p = 0.230). Folate and vitamin B12 levels were lower in the HNE group (p < 0.01). A positive correlation between hemoglobin and survival was present (p < 0.01, r = 0.289), and hemoglobin levels were lower in the deceased population (p < 0.01). CONCLUSION:Anemia is frequent in PEG-patients, mostly with the features of ACD or multifactorial. It is associated with significant decrease in survival and may be viewed as a marker of severe metabolic distress, signaling poor outcome.
Authors: A-L Couderc; J Camalet; S Schneider; J M Turpin; I Bereder; R Boulahssass; S Gonfrier; P Bayer; O Guerin; P Brocker Journal: J Nutr Health Aging Date: 2015-02 Impact factor: 4.075
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