Risk factors associated with early mortality after percutaneous endoscopic gastrostomy in patients at a tertiary care center in Brazil: A retrospective single-center survival study

Abstract

Background – Percutaneous endoscopic gastrostomy (PEG) is the main accepted method for long-term tube feeding. Objective – To investigate the risk factors associated with early mortality after PEG. Methods – Retrospective survival analysis in a tertiary-level center in Recife, Brazil. We reviewed the medical records of 150 patients with PEG placement. The data were analysed by the Kaplan-Meier method. Multivariable Cox proportional regression models were also built to test the effects of PEG on mortality. Results – A total of 150 patients who submitted to PEG were studied (70 male). Of the participants, 87 (58%) had blood hypertension; 51 (34%) patients had diabetes; 6 (4%) patients had chronic renal disease; and 6 (4%) had malignancy. Chronic neurodegenerative diseases were the more common clinical indication for PEG. The 30-day and 60-day proportional mortality probability rates were 11.05% and 15.34% respectively. A multivariate Cox proportional regression model, haemoglobin (HR 4.39, 95% CI 1.30–14.81, P=0.017) and pre-procedure UCI staying (HR 0.66, 95% CI 0.50–0.87, P=0.004) were significant predictors of early mortality. A haemoglobin cut-off value of 10.05 g/dL was shown to have a sensibility of 82.6% (61.2% to 95% CI) and an acceptable sensitivity of 59.0 (50.6% to 68.6% CI), and a likelihood ratio of 2.06 for eight weeks mortality. Conclusion – In patients who had been subjected to the PEG procedure for long-term nutrition, low haemoglobin, pre-procedure intensive care unit internment or both are associated with the risk of early mortality.