Analysis of Risk Factors for Early Tube Exchange in Percutaneous Endoscopic Gastrostomy

ABSTRACT

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a widely-performed procedure for patients undergoing enteral feeding. Due to frequent complications, careful management after the PEG is required. In this study, we investigated the risk factors associated with early exchange of PEG tube. MATERIALS AND METHODS: We did a retrospective survey of 72 patients who received a PEG between January 2009 and April 2014. All patients underwent a tube exchange or removal after the first PEG. Patients who had an exchange within 6 months were defined as 'early exchange' group and the others, as 'late exchange' group. We analyzed the relationship between early exchange and pre-PEG status. RESULTS: Mean age of patients was 67.5+/-18.3 years. The most frequent mental status and performance status before the first procedure, was 'alert' (n=48, 66.7%) and Eastern Cooperative Oncology Group (ECOG) score was 4 (n=28, 39.8%). Mean BMI was 20.2+/-3.7 kg/m2 and the majority of PEG cause was cerebrovascular accidents (n=23, 31.9%). Many patients had a tube exchange (or removal) because of tube dysfunction (n=32, 44.4%). The 'early exchange' group showed a lower BMI than 'late exchange' group (19.7+/-3.57 kg/m2 vs. 22.4+/-3.87 kg/m2, P value 0.009). 'Underweight' (BMI less than 18.5 kg/m2) group was more frequently observed in 'early exchange' group. There was no significant difference in pre-PEG status and post-PEG complication between the 2 groups. CONCLUSIONS: A lower BMI was associated with early exchange of PEG. Health providers should pay attention to the nutritional status of PEG patients.