Skip to main content
Log in

Long-term outcomes of patients receiving percutaneous endoscopic gastrostomy tubes

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) tube placement is the preferred method for long-term enteral feeding of patients who are unable to take food by mouth. Despite the widespread acceptance of the procedure, no large-scale study of the long-term outcomes of patients receiving PEG tubes has been reported. The objective of this study was to determine the survival of patients in whom PEG tubes are placed.

DESIGN: Retrospective cohort study using data obtained from two computerized databases.

SETTING: Department of Veterans Affairs hospitals.

PATIENTS: Seven thousand three hundred sixty-nine patients who received a PEG tube in fiscal years 1990 through 1992.

RESULTS: For the 7,369 patients, the mean age was 68.1 years and 98.6% were men. PEG tubes were most commonly placed in patients with cerebrovascular disease (18.9%), other organic neurologic disease (28.6%), or head and neck cancer (15.7%). Although the complication rate of the procedure itself was low (4%), because of the severity of their underlying disease, 1,732 patients (23.5%) died during the hospitalization in which the PEG tube was placed. The median survival of the full cohort was 7.5 months.

CONCLUSIONS: This study documents the widespread placement of PEG tubes in severely ill patients, half of whom are in the terminal phase of their illness. Further study is needed to determine whether these patients benefit from PEG tube placement in terms of their quality of life and survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Gauderer MWL, Ponsky JL, Izant RJ. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980;15:872–5.

    Article  PubMed  CAS  Google Scholar 

  2. Ponsky JL, Gauderer MWL. Percutaneous endoscopic gastrostomy: a nonoperative technique for feeding gastrostomy. Gastrointest Endosc. 1981;27:9–11.

    PubMed  CAS  Google Scholar 

  3. AGA Health Care Reform Update. American Gastroenterological Association. 1993;1–5.

  4. Larson DE, Burton DD, Schroeder KW, DiMagno EP. Percutaneous endoscopic gastrostomy. Indications, success, complications, and mortality in 314 consecutive patients. Gastroenterology. 1987;93:48–52.

    PubMed  CAS  Google Scholar 

  5. Miller RE, Castlemain B, Lacqua FJ, Kotler DP. Percutaneous endoscopic gastrostomy. Results in 316 patients and review of literature. Surg Endosc. 1989;3:186–190.

    Article  PubMed  CAS  Google Scholar 

  6. Horton WL. Colwell DL, Burlon DT. Experience with percutaneous endoscopic gastrostomy in a community hospital. Am J Gastroenterol. 1991;86:168–70.

    PubMed  CAS  Google Scholar 

  7. Gibson SE, Wenig BL, Watkins JL. Complications of percutaneous endoscopic gastrostomy in head and neck cancer patients. Ann Otol Rhinol Laryngol. 1992;101:46–50.

    PubMed  CAS  Google Scholar 

  8. Grant JP. Percutaneous endoscopic gastrostomy. Initial placement by single endoscopic technique and long-term follow-up. Ann Surg. 1993;217:168–74.

    Article  PubMed  CAS  Google Scholar 

  9. Fuchs VR, Garber AM. The new technology assessment. N Engl J Med. 1990;323:673–7.

    Article  PubMed  CAS  Google Scholar 

  10. Division of Quality Control Management, American Hospital Association. International Classification of Diseases, Ninth Revision, Clinical Modification. Chicago, Ill: American Hospital Publishing Inc; 1989.

    Google Scholar 

  11. Fleming C, Fisher ES, Chang CH, Bubolz TA, Malenka DJ. Studying outcomes and hospital utilization in the elderly. The advantages of a merged data base for Medicare and Veterans Affairs hospitals. Med Care. 1992;30:377–91.

    Article  PubMed  CAS  Google Scholar 

  12. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Statist Assoc. 1958;53:457–81.

    Article  Google Scholar 

  13. Jain NK, Larson DE, Schroeder KW, et al. Antibiotic prophylaxisfor percutaneous endoscopic gastrostomy. A prospective, randomized, double-blind clinical trial. Ann Intern Med. 1987;107:824–8.

    PubMed  CAS  Google Scholar 

  14. Park RHR, Allison MC, Lang J, et al. Randomized comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ. 1992;304:1406–9.

    PubMed  CAS  Google Scholar 

  15. Rabeneck L. Why should gastroenterologists know about outcomes research? Gastrointest Endosc. 1993;39:723–5.

    Article  PubMed  CAS  Google Scholar 

  16. Wolfsen HC, Kozarek RA, Ball TJ, Patterson DJ, Botoman VA, Ryan JA. Long-term survival in patients undergoing percutaneous endoscopic gastrostomy and jejunostomy. Am J Gastroenterol. 1990;85:1120–2.

    PubMed  CAS  Google Scholar 

  17. Fay DE, Poplausky M, Gruber M, Lance P. Long-term enteral feeding: a retrospective comparison of delivery via percutaneous endoscopic gastrostomy and nasoenteric tubes. Am J Gastroenterol. 1991;86:1604–9.

    PubMed  CAS  Google Scholar 

  18. Taylor CA, Larson DE, Ballard DJ, et al. Predictors of outcome after percutaneous endoscopic gastrostomy: a community-based study. Mayo Clin Proc. 1992;67:1042–9.

    PubMed  CAS  Google Scholar 

  19. Brook RH, Park RE, Chassin MR, Solomon DH, Keesey J, Kosecoff J. Predicting the appropriate use of carotid endarterectomy, upper gastrointestinal endoscopy, and coronary angiography. N Engl J Med. 1990;323:1173–7.

    Article  PubMed  CAS  Google Scholar 

  20. Chassin MR, Kosecoff J, Park RE, et al. Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures. JAMA. 1987;258:2533–7.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

From the Department of Veterans Affairs Health Services Research and Development (HSR&D) Field Program, and the Department of Medicine, Baylor College of Medicine, Houston, Tex.

Supported by the Department of Veterans Affairs Health Services Research and Development Houston Field Program.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rabeneck, L., Wray, N.P. & Petersen, N.J. Long-term outcomes of patients receiving percutaneous endoscopic gastrostomy tubes. J Gen Intern Med 11, 287–293 (1996). https://doi.org/10.1007/BF02598270

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02598270

Key words

Navigation