BIOGRAPHY
Currently a dual advanced trainee in General and Acute Medicine and Gastroenterology, working in Hawkes Bay DHB. ABSTRACT Retrospective analysis of Percutaneous Endoscopic Gastrostomy placement
Russell C1, Hawkes Bay District Health Board, New Zealand1 Context
Percutaneous endoscopic gastrostomy (PEG) placement improves morbidity and mortality in appropriately selected patients. Associated risks are significant, with ongoing education to clinicians regarding indications and timing, as well as review of our clinical practice, required to minimise complications.
Aim
Review PEG indications, insertional delay, procedural details, complications and mortality. Comparison analysis of outcomes with international statistics and guidelines to reflect on clinical practice.
Methods
Retrospective analysis of PEGs at Hawkes Bay Hospital January 2011 to April 2015. Review of procedural note, discharge summaries, clinical nurse specialist reviews and microbiology results. Results compared with international standards.
Results
78 eligible patients aged 17-93 (mean 66), 68% males, inserted by gastroenterologists with 60% requiring general-anaesthetic and 80% documented antibiotic cover. Indications varied; 35% acute neurological (8% traumatic brain injury), 30% head and neck malignancies, 12% chronic degenerative neurological with remainder motility disorders, gastroparesis, aspiration pneumonia, dementia and refusal of oral intake. Mean insertional delay 19 days, with majority of referrals from General Medicine/ Geriatricians (40%), Oncology (26%) and Neurology (15%). Thirty day all cause mortality was 9.0%.
Peri and Post-procedural Complications
 Conclusion
Majority of indications and procedural techniques in keeping with international guidelines. Complication rates comparable to past statistical analyses, with 30 day mortality 9% compared with international levels of 19%1.
References
1. Schrag et al.Complications Related to PEG Tubes.Comprehensive Clinical Review.J Gastrointestin Liver Dis.2007;16(4):407-418
2. Potack and Chokhavatia.Complications and Controversies Associated With PEG:Report of Case and Literature Review.Medscape J Med.2008;10(6):142.
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