Complications and Mortality After Percutaneous Endoscopic Gastrostomy in Geriatrics: A Prospective Multicenter Observational Trial
Abstract
Background Generally, the high short-term mortality after percutaneous endoscopic gastrostomy (PEG) in geriatric patients is attributed to the severity of their underlying diseases. However, the procedure-related mortality in this group is unknown. Methods This prospective multicenter observational study gathered information about 197 geriatric patients treated with PEG insertion, including the indication for PEG insertion and the prevalence of postprocedure complications and analyzed how these factors related to mortality. Results Dysphagia (64%) and insufficient food intake (76%) were the most frequent indications for PEG insertion. Severe complications after PEG insertion occurred in 9.6% of patients. Mortality was 9.6% in hospital, as well as 18.4% at 1 month. Six months after PEG placement, with 81 patients lost to follow-up, mortality was 51.9%. Hospital mortality was significantly higher in patients with severe complications caused by PEG insertion (47.4% vs 5.6%; P Conclusion Although the prevalence of complications after PEG in this study of multimorbid geriatric patients is within the expected range, the procedure-related mortality is higher than expected.
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Several risk factors for early mortality after PEG insertion were identified, e.g. dementia, urinary tract infection, previous aspiration and diabetes.
“Several risk factors for early mortality after PEG insertion were identified, e.g.dementia, urinary tract infection, previous aspiration and diabetes (132-136, 149, 156-159).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [136]
In individual patients, both nasogastric tube feeding and PEG feeding may be harmful.
“Complication rates of EN are reported to be generally low (160), but in individual patients, both nasogastric tube feeding and PEG feeding may be harmful (136, 161).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [136]
Survival after PEG insertion very much depends on the indication and selection of patients.
“However, survival very much depends on the indication and selection of patients (132-137).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [136]
Some studies show that a substantial weight loss has frequently occurred before the initiation of EN, i.e. on average 11.4 kg in the study by Loser et al.
“Some studies show that a substantial weight loss has frequently occurred before the initiation of EN, i.e. on average 11.4 kg in the study byLoser et al. (128, 136).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [136]
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ESPEN practical guideline: Clinical nutrition and hydration in geriatrics
Volkert, D., Beck, A. M., Cederholm, T., Cruz-Jentoft, A., Hooper, L., Kiesswetter, E., Maggio, M., Raynaud-Simon, A., Sieber, C., Sobotka, L., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.01.024 · Cited by 516 · see citing works
Self-citation
- Authors
- Wirth, R., Voss, C., Smoliner, C., Sieber, C. C., Bauer, J. M., & Volkert, D.
- Affiliations
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Corresponding author
- Wirth, Rainer
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 13
- Issue
- 3
- Pages
- 228-233
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W2032865500
- Cited by
- 41
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 6 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 1
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- percutaneous endoscopic gastrostomy, elderly patients, post-procedure complications, mortality, peritonitis, wound infection, dysphagia, procedure-related mortality, multimorbidity
- MeSH terms
- Aged, Aged, 80 and over, Female, Geriatric Nursing, Germany, Hospital Departments, Humans, Male, Prospective Studies, Endoscopy, Gastrointestinal
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