Low Abdominal Wall Thickness May Predict Percutaneous Endoscopic Gastrostomy Complications
| Autor: | Vanessa P. Ho, Richard J Tom, Taylor R. Klein, Melissa K. James, Gloria M Melnic, Sebastian D. Schubl, Simon P Tiu |
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| Rok vydání: | 2017 |
| Předmět: |
education.field_of_study
medicine.medical_specialty business.industry Mortality rate medicine.medical_treatment Population Retrospective cohort study General Medicine medicine.disease Gastrostomy Surgery Abdominal wall 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Diabetes mellitus Percutaneous endoscopic gastrostomy medicine 030211 gastroenterology & hepatology education business Body mass index |
| Zdroj: | The American Surgeon. 83:183-190 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481708300219 |
| Popis: | Although percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure to provide enteral feeding, some patients develop complications. The aim of this study was to identify risk factors for the development of post-PEG complications. We hypothesized that patients with low albumin, diabetes, higher body mass index (BMI), thicker abdominal walls, or psychomotor agitation would have more complications. A 2-year retrospective review was performed on patients who received a PEG tube at a single institution. Variables collected included age, preoperative albumin, BMI, abdominal wall thickness (AWT), psychomotor agitation, pre-operative diabetes mellitus, and mortality. A total of 91 patients (70.3% male) were identified (mean age 58.7 years, SD 18.6). Seventeen patients (18.7%) had post-PEG complications and the 30-day mortality rate was 14.3 per cent. Mortality was not attributable to tube placement. Patients with complications weighed less (P = 0.005) and had a lower BMI (P = 0.010) than patients without complications. Additionally, patients with complications had significantly lower AWT (P = 0.02), mean AWT was 21.6 mm (SD 7.6) versus 27.6 mm (SD 8.1) in the noncomplication patients. AWT was the only factor independently associated with post-PEG complications (P = 0.047). There was no significant association between complications and mortality. Continued investigation on how to limit post-PEG complications remains imperative. In our population, lower AWT was independently associated with complications. Preoperative measurement of AWT by pre-procedural imaging can potentially be used to predict the risk of post-PEG complications. |
| Databáze: | OpenAIRE |
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