Percutaneous endoscopic gastrostomy: confirming the clinical benefits far beyond anthropometry. Issue 9 (September 2017)

• Record Type: Journal Article
• Authors: Cúrdia, Gonçalves T.; Marinho, Carla; Magalhães, Joana; Barbosa, Mara; Monteiro, Sara; Dias de Castro, Francisca; Boal Carvalho, Pedro; Rosa, Bruno; Figueiredo, Lília; Cotter, José
• Is Part Of: European journal of gastroenterology & hepatology. Volume 29:Issue 9(2017:Sep.)
• Publication Date: 2017-09
• Subjects: anthropometry -- clinical benefits -- hospitalization -- hydration -- nutrition -- percutaneous endoscopic gastrostomy -- pressure ulcers; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000000923
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Objectives: The real benefit of gastrostomy is still a matter of debate. We aimed to prospectively evaluate the global impact of percutaneous endoscopic gastrostomy (PEG) in patients followed at a specialized multidisciplinary clinic, namely, the impact on the need for healthcare resources, anthropometric measures, pressure ulcers prevention and healing, and nutritional and hydration status. Patients and methods: From the 201 patients who underwent PEG between May 2011 and September 2014, 60 were included in a prospective study. Anthropometric, clinical, and laboratorial variables were collected and compared before and after PEG. Follow-up duration, mortality, and number of emergency department visits or hospital admissions were also assessed. Results: Thirty-three (55.0%) patients were women and the median age was 79 years. The main indications for PEG were dementia (43.3%) and poststroke dysphagia (30.0%). Four months following PEG, significant decreases in the tricipital skinfold ( P =0.002) and brachial perimeter ( P =0.003) were found. A decrease in the mean number of hospitalizations (1.4 vs. 0.3; P <0.001) and visits to emergency department (2.2 vs. 1.1; P =0.003) was noted in the next 6 months after PEG compared with the previous semester. In 53.8% of patients with pressure ulcers, complete healing was observed after PEG. PEG was associated with increases in hemoglobin ( P =0.024), lymphocytes ( P =0.041), cholesterol ( P =0.008), transferrin ( P <0.001), albumin ( P <0.001), and total proteins ( P <0.001), and a decrease in serum sodium ( P =0.001). Conclusion: Anthropometric values may not translate the early benefits of a gastrostomy. PEG decreases the need for hospital health care, facilitates healing of pressure ulcers, and induces biochemical changes that may reflect better nutrition and hydration.