Mortality of percutaneous endoscopic gastrostomy in the UK
GI Leontiadis, J Moschos, T Cowper, Sawas Kadis
Department of Gastroenterology, Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE6 9SX, United Kingdom
Department of Gastroenterology, Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE6 9SX
|How to cite this article:|
Leontiadis G I, Moschos J, Cowper T, Kadis S. Mortality of percutaneous endoscopic gastrostomy in the UK.J Postgrad Med 2005;51:152-152
|How to cite this URL:|
Leontiadis G I, Moschos J, Cowper T, Kadis S. Mortality of percutaneous endoscopic gastrostomy in the UK. J Postgrad Med [serial online] 2005 [cited 2020 Apr 7 ];51:152-152
Available from: http://www.jpgmonline.com/text.asp?2005/51/2/152/16386
We read with great interest the original article by Janes et al and the accompanying Expert's Comments by Lang published in the March 2005 issue of J Postgrad Med . Janes et al found that 30-day mortality of percutaneous endoscopic gastrostomy (PEG) was 22% in a hospital in the UK during 2002 as opposed to a mortality of 10% 10 years earlier. This increase in mortality was attributed to a trend for less strict patient selection over the last few years.
We wish to support the findings of the above study by providing the results of a prospective audit we conducted in another hospital in the UK over the same period. All patients that received PEG in our hospital over a period of 38 months (May 1999 to June 2002) were followed up until reversion to oral feeding or until death. Seventy-three patients received PEG (mean age 71.7 years). The indications for PEG insertion were: cerebrovascular accident (CVA) 56.1%; non-CVA dementia 30.1%; other organic neurological diseases 11%; malignancy-associated anorexia 1.4%; neck cancer 1.4%.
Overall mortality over the follow-up period was 64.4%. In specific, early mortality (within 4 weeks) was 23.3%, mid-term mortality (4-8 weeks) 11% and late mortality (>8 weeks) 30.1%. Causes of death were: chest infection 83%; myocardial infarction 4%; congestive cardiac failure 6.4%; pulmonary embolism 2.1%; progression of pre-existing malignancy 2.1%. Mortality was 82% for patients with non-CVA dementia and 54% for patients with CVA, P = 0.05. No differences were found in survival and in complication rate between patients discharged home (11 patients) and those referred to nursing homes or long-term hospital care (26 patients).
In conclusion, 30-day mortality following PEG insertion is high in British hospitals. Our findings are remarkably similar to the findings of Janes et al . Local and national guidelines on indications for PEG insertion need to be developed. Based on these guidelines a local multidisciplinary team should assess individually each request for PEG insertion.
|1||Janes SE, Price CS, Khan S. Percutaneous endoscopic gastrostomy: 30-day mortality trends and risk factors. J Postgrad Med 2005;51:23-9.|
|2||Lang A. Percutaneous endoscopic gastrostomy. J Postgrad Med 2005;51:28-9.|