부산대학교 도서관

Introduction: Since the inception of PEG feeding 20 years ago its utilization has continued to increase leading to concern regarding its overutilization, however, PEG feeding facilitates nursing care in patients unable to tolerate oral feeding. The aim of this study was to assess the current indications and complications associated with PEG and to evaluate the concern regarding overutilization. Methods: We performed a 5-year retrospective review of PEG tube placement in a university teaching hospital during the period January 1995 to March 2000. Two hundred and thirty-eight patients had attempted PEG tube placement, of which adequate follow up records were available for 205 (84 per cent). Of these 193 (94 per cent) had successful placement. Results: The number of PEG tubes inserted has increased annually from 37 in 1995 to 65 in 1999. The indications for insertion were for central nervous disease 76 per cent (n = 156), other benign lesions 14 per cent (n = 28) and malignant lesions 10 per cent (n = 21). Cerebrovascular accidents (CVA) alone accounted for 47 per cent (n = 97). There were four deaths (2 per cent) related to PEG placement, which included three aspiration pneumonias and one case of peritonitis. There were six (3 per cent) major complications, which included peritonitis, perforation and aspiration pneumonia. Ninety-seven (50 per cent) patients had minor complications, which included 33 (17 per cent) tube leakages, 43 (22 per cent) wound infections and five (3 per cent) aspiration pneumonias. There were 14 (6 per cent) failed insertions and 12 (6 per cent) occlusions. Twenty-nine patients (15 per cent) required the PEG to be replaced. The overall 30 day mortality rate was 16 per cent. There was a 20 per cent 30-day mortality (n = 19) in the CVA group compared to 11 per cent (n = 11) in the non-CVA group which was felt to reflect the nature of the disease and not the procedure itself. Conclusion: Percutaneous endoscopic gastrostomy has a morbidit... [ABSTRACT FROM AUTHOR]