Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study

Andrea Anderloni, Milena Di Leo, Franco Barzaghi, Rossella Semeraro, Gianmichele Meucci, Roberta Marino, Loretta Amato, Mauro Frigerio, Valeria Saladino, Anna Toldi, Guido Manfredi, Alessandro Redaelli, Marcella Feliziani, Giuseppe De Roberto, Francesca Boni, Gianlorenzo Scacchi, Davide Mosca, Massimo Devani, Monica Arena, Marco MassiddaPaolo Zanoni, Camilla Ciscato, Valentina Casini, Paolo Beretta, Edoardo Forti, Raffaele Salerno, Vitantonio Caramia, Mario Bianchetti, Carolina Tomba, Andrea Evangelista, Alessandro Repici, Marco Soncini, Giovanni Maconi, Gianpiero Manes, Renzo Gullotta

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. Aim: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. Methods: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. Results: 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0–1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77−0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. Conclusions: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.

Original languageEnglish
JournalDigestive and Liver Disease
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Gastrostomy
Cohort Studies
Prospective Studies
Mortality
Consent Forms
Nutritional Support
Incidence
Patient Selection
Italy
Comorbidity
Hemorrhage
Infection

Keywords

  • Complications
  • Mortality
  • PEG
  • Risk factors
  • Short-term outcome

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy : A multicenter prospective cohort study. / Anderloni, Andrea; Di Leo, Milena; Barzaghi, Franco; Semeraro, Rossella; Meucci, Gianmichele; Marino, Roberta; Amato, Loretta; Frigerio, Mauro; Saladino, Valeria; Toldi, Anna; Manfredi, Guido; Redaelli, Alessandro; Feliziani, Marcella; De Roberto, Giuseppe; Boni, Francesca; Scacchi, Gianlorenzo; Mosca, Davide; Devani, Massimo; Arena, Monica; Massidda, Marco; Zanoni, Paolo; Ciscato, Camilla; Casini, Valentina; Beretta, Paolo; Forti, Edoardo; Salerno, Raffaele; Caramia, Vitantonio; Bianchetti, Mario; Tomba, Carolina; Evangelista, Andrea; Repici, Alessandro; Soncini, Marco; Maconi, Giovanni; Manes, Gianpiero; Gullotta, Renzo.

In: Digestive and Liver Disease, 01.01.2019.

Research output: Contribution to journalArticle

Anderloni, A, Di Leo, M, Barzaghi, F, Semeraro, R, Meucci, G, Marino, R, Amato, L, Frigerio, M, Saladino, V, Toldi, A, Manfredi, G, Redaelli, A, Feliziani, M, De Roberto, G, Boni, F, Scacchi, G, Mosca, D, Devani, M, Arena, M, Massidda, M, Zanoni, P, Ciscato, C, Casini, V, Beretta, P, Forti, E, Salerno, R, Caramia, V, Bianchetti, M, Tomba, C, Evangelista, A, Repici, A, Soncini, M, Maconi, G, Manes, G & Gullotta, R 2019, 'Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study', Digestive and Liver Disease. https://doi.org/10.1016/j.dld.2019.03.024
Anderloni, Andrea ; Di Leo, Milena ; Barzaghi, Franco ; Semeraro, Rossella ; Meucci, Gianmichele ; Marino, Roberta ; Amato, Loretta ; Frigerio, Mauro ; Saladino, Valeria ; Toldi, Anna ; Manfredi, Guido ; Redaelli, Alessandro ; Feliziani, Marcella ; De Roberto, Giuseppe ; Boni, Francesca ; Scacchi, Gianlorenzo ; Mosca, Davide ; Devani, Massimo ; Arena, Monica ; Massidda, Marco ; Zanoni, Paolo ; Ciscato, Camilla ; Casini, Valentina ; Beretta, Paolo ; Forti, Edoardo ; Salerno, Raffaele ; Caramia, Vitantonio ; Bianchetti, Mario ; Tomba, Carolina ; Evangelista, Andrea ; Repici, Alessandro ; Soncini, Marco ; Maconi, Giovanni ; Manes, Gianpiero ; Gullotta, Renzo. / Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy : A multicenter prospective cohort study. In: Digestive and Liver Disease. 2019.
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abstract = "Background: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. Aim: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. Methods: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. Results: 950 patients (47.1{\%} male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5{\%} of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8{\%} and 5.2{\%}, respectively. The most frequent complication was infection (50{\%}), followed by bleeding (32.1{\%}), tube dislodgment (14.3{\%}), and buried bumper syndrome (3.6{\%}). At multivariable analysis, age (OR 1.08 per 1-year increase, 95{\%} CI, 1.0–1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95{\%} CI, 0.77−0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8{\%}, while complications occurred in 1.7{\%} of patients. Conclusions: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.",
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T1 - Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy

T2 - A multicenter prospective cohort study

AU - Anderloni, Andrea

AU - Di Leo, Milena

AU - Barzaghi, Franco

AU - Semeraro, Rossella

AU - Meucci, Gianmichele

AU - Marino, Roberta

AU - Amato, Loretta

AU - Frigerio, Mauro

AU - Saladino, Valeria

AU - Toldi, Anna

AU - Manfredi, Guido

AU - Redaelli, Alessandro

AU - Feliziani, Marcella

AU - De Roberto, Giuseppe

AU - Boni, Francesca

AU - Scacchi, Gianlorenzo

AU - Mosca, Davide

AU - Devani, Massimo

AU - Arena, Monica

AU - Massidda, Marco

AU - Zanoni, Paolo

AU - Ciscato, Camilla

AU - Casini, Valentina

AU - Beretta, Paolo

AU - Forti, Edoardo

AU - Salerno, Raffaele

AU - Caramia, Vitantonio

AU - Bianchetti, Mario

AU - Tomba, Carolina

AU - Evangelista, Andrea

AU - Repici, Alessandro

AU - Soncini, Marco

AU - Maconi, Giovanni

AU - Manes, Gianpiero

AU - Gullotta, Renzo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. Aim: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. Methods: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. Results: 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0–1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77−0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. Conclusions: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.

AB - Background: Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support. Aim: To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement. Methods: All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed. Results: 950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0–1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77−0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients. Conclusions: Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.

KW - Complications

KW - Mortality

KW - PEG

KW - Risk factors

KW - Short-term outcome

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