Original ArticlesA prospective evaluation of outcome in patients referred for PEG placement☆,☆☆
Section snippets
Patients and methods
All adult patients for whom gastroenterology consultation was sought for feeding PEG placement from October 1997 to December 1998 at our institution, an urban academic medical center, were eligible for the study. PEG placement was requested by the patients' primary physicians by means of the gastroenterology consultation service. Those patients in whom PEG placement was for the sole purpose of gastric decompression were excluded from the study. Each case was reviewed by the gastroenterology
Results
Sixty-seven consultations were requested for evaluation of feeding PEG placement over the 14-month study period. The outcome of these patients is summarized in Figure 1.Three patients died within 24 hours of the consultation requested, before initial evaluation by the gastroenterology service. Sixty-four patients (63 inpatients and 1 outpatient) were evaluated for PEG placement. Of these, 6 were excluded because informed consent for
Discussion
Although PEG is now widely available, its impact on patient quality and quantity of life has not been extensively studied in a prospective fashion. There is a debate in the medical community regarding the provision of palliative care to those individuals who lack decision-making capacity.19 Requests for feeding gastrostomies are common in this particular group of patients, especially those who are unable to maintain sufficient caloric intake because of advanced dementia. The 30-day mortality
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Cited by (35)
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2021, Gastrointestinal EndoscopyCitation Excerpt :Factors predicting mortality after PEG are known. Advanced age, male, hypo-albuminemia, increased CRP levels, presence of heart failure, and high CCI score are risk factors for mortality.23-26 Our analysis of the PEG group revealed a similar tendency.
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2013, Journal de Chirurgie VisceralePredicting the outcome of artificial nutrition by clinical and functional indices
2009, NutritionCitation Excerpt :The role of AN in age is controversial. Although some studies found no relation between age and mortality at 30 d after PEG placement [3,4], there are reports indicating the existence of a causative relation [7]. Conceptually, age should be related to the patients' prognosis and the outcome of AN, considering that it is the main determinant of frailty [19,30].
Survival of elderly persons undergoing colonoscopy: implications for colorectal cancer screening and surveillance
2007, Gastrointestinal EndoscopyCitation Excerpt :Comorbidity was assessed by using the Charlson comorbidity index,27 a validated scoring system used to predict mortality in longitudinal studies. We used a modified version that had previously been used in a study assessing the outcome of patients undergoing percutaneous endoscopic gastrostomy tube placement28 (Table 1). Subjects were classified into asymptomatic (screening, polyp surveillance, and evaluation of positive fecal occult blood tests) and symptomatic (abdominal pain, bleeding, weight loss, altered bowel habits).
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Reprint requests: Richard C. K. Wong, MBBS, FACP, University Hospitals of Cleveland, Division of Gastroenterology, 11100 Euclid Ave., Cleveland, Ohio 44106-5066.
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R.C.K.W. was the recipient of the 1999 ASGE/ADHF Wilson-Cook Endoscopic Research Career Development Award.