PERCUTANEOUS ENDOSCOPIC GASTROSTOMY - A COMMUNITY-HOSPITAL EXPERIENCE

Percutaneous endoscopic gastrostomy (PEG) is a well established proced ure for establishing a feeding port in patients unable to take oral nu trition. As these patients are often elderly with multiple ailments, m ortality due to comorbidities is common. This retrospective study revi ewed the experience with PEG in a community hospital, with particular attention paid to morbidity and mortality rates. Randomly selected cha rts of 100 patients who had PEG performed at our hospital between 1987 and 1991 were examined. These records were reviewed for patients' age , gender, indications, intraoperative complications, and final disposi tion. Procedure-related morbidity was defined as any untoward event or death that could not be directly attributed to the patient's primary disease process. The sample consisted of 33 males and 67 females whose ages ranged from 47 to 102 years, with a mean of 82 years. The most c ommon indications were malnutrition (n = 48) and dysphagia due to neur ological problems (n = 38). The only procedure-related intraoperative complication involved a patient with uncomplicated umbilical hernia wh o developed stragulation. The morbidity rate was 4% and the 30-day mor tality rate was 16%. Only one death was directly related to the PEG tu be, and a second death was possibly related to the PEG tube. This comm unity hospital's experience with PEG reveals low morbidity and mortali ty rates compared to Stamm gastrostomy. These results confirm that PEG is the procedure of choice for providing aging patients with a safe r oute for enteral nutrition.