PWE-110 unvetted pig versus peg service with nutrition support team. have we improved mortality?. (8th June 2018)
- Record Type:
- Journal Article
- Title:
- PWE-110 unvetted pig versus peg service with nutrition support team. have we improved mortality?. (8th June 2018)
- Main Title:
- PWE-110 unvetted pig versus peg service with nutrition support team. have we improved mortality?
- Authors:
- Chatten, Kelly
Brennan, Fiona
Donald, Kirsty
Moran, Michelle
Ridings, Emma
McCann, Steven
Burrows, Gillian
Jafar, Wisam - Abstract:
- Abstract : Introduction: The 2004 NCEPOD report highlighted the high 30 day mortality following PEG (percutaneous endoscopic gastrostomy) insertion secondary to inappropriate patient selection[1]. This led to the 2010 BSG guidelines which recommended that a designated nutrition support team (NST) should provide a framework for patient selection to reduce unsuitable patients receiving PEGs[2]. Prior to 2013 in Stockport NHS Foundation trust PIGs (per-oral image-guided gastrostomy) were inserted or patients referred to another trust for PEG placement. There was no formalised referral or screening process. Subsequently a nutrition team was appointed with inpatient assessment of patients and MDT for complex cases. Our Aim was to assess whether the implementation of a nutritional team PEG service reduced 30 day all-cause mortality. Methods: Retrospective analysis of electronic patient records for 30 day all-cause mortality for all PIG and PEG insertions between 2013 and 2017. Statistical analysis was performed using chi-squared. Results: 48 patients (2 excluded as paediatric case and no notes available) had a PIG inserted without formal nutrition team review and 135 patients had PEG following nutrition nurse or MDT assessment. The 2 groups were similar with an average age of 79 years (PIG) and 76 years (PEG) and the majority inserted for stroke (62% PIG and 50% PEG). 30 day mortality on the non-vetted PIG group was 17.4% compared to 5.2% in the PEG group. This was statisticallyAbstract : Introduction: The 2004 NCEPOD report highlighted the high 30 day mortality following PEG (percutaneous endoscopic gastrostomy) insertion secondary to inappropriate patient selection[1]. This led to the 2010 BSG guidelines which recommended that a designated nutrition support team (NST) should provide a framework for patient selection to reduce unsuitable patients receiving PEGs[2]. Prior to 2013 in Stockport NHS Foundation trust PIGs (per-oral image-guided gastrostomy) were inserted or patients referred to another trust for PEG placement. There was no formalised referral or screening process. Subsequently a nutrition team was appointed with inpatient assessment of patients and MDT for complex cases. Our Aim was to assess whether the implementation of a nutritional team PEG service reduced 30 day all-cause mortality. Methods: Retrospective analysis of electronic patient records for 30 day all-cause mortality for all PIG and PEG insertions between 2013 and 2017. Statistical analysis was performed using chi-squared. Results: 48 patients (2 excluded as paediatric case and no notes available) had a PIG inserted without formal nutrition team review and 135 patients had PEG following nutrition nurse or MDT assessment. The 2 groups were similar with an average age of 79 years (PIG) and 76 years (PEG) and the majority inserted for stroke (62% PIG and 50% PEG). 30 day mortality on the non-vetted PIG group was 17.4% compared to 5.2% in the PEG group. This was statistically significant with p=0.0048 Conclusions: For the unassessed PIG service mortality was similar to that detailed by the NCEPOD report, demonstrating that despite this and BSG guidelines attitudes towards PEG/PIG insertion among non-specialists have not changed since 2004. By introducing an NTS and PEG service mortality has reduced significantly. With an ever increasing ageing population, trends in PEG placement are rising[3]. It is a necessity to ensure that patients are being appropriately assessed to prevent futile procedures. References: . Ponsky JL. Percutaneous Endoscopic Gastrostomy 2004;719 :901–4. doi:10.1016/j.gassur.2003.12.002 . Westaby D, Young A, O'Toole P, et al. The provision of a percutaneously placed enteral tube feeding service. Gut 2010;59 :1592–605. doi:10.1136/gut.2009.204982 . Mendiratta P, Tilford JM, Prodhan P, et al. Trends in percutaneous endoscopic gastrostomy Placement in the Elderly From 1993 to 2003. Am J Alzheimer's Dis Other Dementiasr 2012;27 :609–13. doi:10.1177/1533317512460563 … (more)
- Is Part Of:
- Gut. Volume 67(2018)Supplement 1
- Journal:
- Gut
- Issue:
- Volume 67(2018)Supplement 1
- Issue Display:
- Volume 67, Issue 1 (2018)
- Year:
- 2018
- Volume:
- 67
- Issue:
- 1
- Issue Sort Value:
- 2018-0067-0001-0000
- Page Start:
- A173
- Page End:
- A173
- Publication Date:
- 2018-06-08
- Subjects:
- Gastroenterology -- Periodicals
616.33 - Journal URLs:
- http://gut.bmjjournals.com ↗
http://www.bmj.com/archive ↗ - DOI:
- 10.1136/gutjnl-2018-BSGAbstracts.344 ↗
- Languages:
- English
- ISSNs:
- 0017-5749
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 19701.xml