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| Year : 2005 | Volume
: 51
| Issue : 2 | Page : 152 |
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
Correspondence Address:
Sawas Kadis
Department of Gastroenterology, Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE6 9SX
United Kingdom
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 16006716 
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 |
Sir,
We read with great interest the original article by Janes et al[1] and the accompanying Expert's Comments by Lang[2] 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 .[1] 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.
| :: References | |  |
| 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. |
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| Suzuki, Y., Urashima, M., Ninomiya, H., Sowa, M., Hiki, Y., Suzuki, H., Ishibashi, Y., et al | | Japan Medical Association Journal. 2006; 49(3): 94-105 | | [Pubmed] | |
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