Risk Factors for Complications of Percutaneous Endoscopic Gastrostomy

Abstract

Background Percutaneous endoscopic gastrostomy (PEG) is a commonly performed procedure for patients with severedysphagia leading to malnutrition. Improved knowledge of risk factors for PEG-related complications might decreasepatient discomfort and healthcare costs.Aim The aim of the present study was to investigate factors associated with complications after PEG.Methods A retrospective review was performed for all patients referred for PEG placement from December 2002 to December 2012 in single-tertiary care center. PEGrelatedcomplications and risk factors were evaluated through chart reviews, endoscopic reports, and endoscopic and radiologic images.Results Among a total of 245 consecutive individuals (146 male, mean age 59.2 ± 12.6 years) enrolled, 43 majorcomplications had developed. Multivariate analysis revealed that patients with an internal bolster of a PEG tubein the upper body of stomach were at significant risk for early [OR 6.127 (95 % CI 1.447?26.046)] and late complications[OR 6.710 (95 % CI 1.692?26.603)]. Abnormal leukocyte counts [OR 3.198 (95 % CI 1.174?8.716)],stroke as an indication for PEG [OR 3.047 (95 % CI 1.174?8.882)], and PEG tube placement by an inexperienced endoscopist [OR 3.401 (95 % CI 1.073?10.779)]were significantly associated with early complications.Conclusions A PEG tube should not be inserted into the upper body of stomach to reduce complication risk, and PEG procedures should be performed by skilled endoscopiststo prevent early complications. An abnormal leukocyte count can be a predictor of early complication, andcare is needed when PEG is performed for patients with stroke.