Factors predictive of survival after percutaneous endoscopic gastrostomy in the elderly: is dementia really a risk factor?
Am J Gastroenterol
; 103(4): 1011-6; quiz 1017, 2008 Apr.
Article
de En
| MEDLINE
| ID: mdl-18177448
ABSTRACT
OBJECTIVES:
Outcomes, especially survival, after percutaneous endoscopic gastrostomy (PEG) in patients with dementia remain unclear. The aims of this study were to assess the impact of dementia on survival after PEG and to explore the risk factors in elderly patients.METHODS:
A total of 311 consecutive Japanese patients who underwent PEG were enrolled in this retrospective cohort study. Dementia was defined according to the standard criteria. After the clinical characteristics of patients with and without dementia were compared, the Kaplan-Meier method and Cox proportional-hazards regression analysis were applied to analyze survival rates.RESULTS:
Survival was not significantly different between the two groups. The 12-month survival rate of patients with dementia (N = 143) was 51%, and that of patients without dementia (N = 168) was 49%. More than 20% of patients with dementia lived more than 3 yr after PEG. The predictors of poor survival after PEG were previous subtotal gastrectomy (odds ratio [OR] 2.619, 95% confidence interval [CI] 1.367-5.019), serum albumin <2.8 g/dL (OR 2.081, 95% CI 1.490-2.905), age >80 yr (OR 1.721, 95% CI 1.234-2.399), chronic heart failure (OR 1.541, 95% CI 1.096-2.168), and male gender (OR 1.407, 95% CI 1.037-1.909).CONCLUSIONS:
In our series, there was no evidence to support a poorer prognosis after PEG in elderly people with dementia compared with the cognitively preserved elderly. However, if patients are male or of advanced age, have a low serum albumin, chronic heart failure, or subtotal gastrectomy, physicians should inform families that a poor prognosis is expected before performing PEG.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Gastrostomie
/
Endoscopie gastrointestinale
/
Démence
Type d'étude:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Aged
/
Female
/
Humans
/
Male
Pays/Région comme sujet:
Asia
Langue:
En
Journal:
Am J Gastroenterol
Année:
2008
Type de document:
Article
Pays d'affiliation:
Japon
Pays de publication:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA