How are decisions made about the use of percutaneous endoscopic gastrostomy for long-term nutritional support?

OBJECTIVE: We sought to study the process by which decisions to commit indi viduals to long-term nutritional support via percutaneous endoscopic gastro stomy (PEG) are made. METHODS: A semistructured questionnaire was administered to surrogates and patients in 73 cases of persons undergoing PEG. RESULTS: Such decisions are often made with inadequate information regardin g the PEG and its possible impact on the future clinical course, sometimes with an overly optimistic view of the prognosis. Several factors may influe nce this process. In cases in which the underlying illness was severe, 30% of surrogate decisionmakers expressed some uncertainty that a right decisio n was made. CONCLUSIONS: The decision to commit patients to long-term nutritional suppo rt via PEG is often difficult and the implications of such a commitment may have major implications for patients and their families. Strategies to opt imize this decisionmaking process are recommended. (C) 1999 by Am. Cell. of Gastroenterology.