Factors Associated With Short-Term Complications After Percutaneous Endoscopic Gastrostomy Tube Insertion: A Retrospective Cohort Study

Mostafa Shehata; Ibrahim Al Hosani; Ishtiaq Ahmed; Heba Abu Alkas; Omar Khaddam; Abd Allah Aljanahi; Maryam Al Ahmad; Khalifa Al Tiniji; Yashbir Singh; Talha Malik

doi:10.7759/cureus.55741

Factors Associated With Short-Term Complications After Percutaneous Endoscopic Gastrostomy Tube Insertion: A Retrospective Cohort Study

Cureus. 2024 Mar 7;16(3):e55741. doi: 10.7759/cureus.55741. eCollection 2024 Mar.

Affiliations

¹ Gastroenterology, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, ARE.
² Internal Medicine, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, ARE.
³ Radiology, Mayo Clinic, Rochester, USA.
⁴ Gastroenterology, Mayo Clinic, Jacksonville, USA.

Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) tube placement is generally safe but is associated with a range of complications. Minor complications include infections, granuloma formation, leakage, and blockages, while major complications encompass aspiration pneumonia, hemorrhage, and more serious conditions such as necrotizing fasciitis and colonic fistula.

Aim: This study aimed to assess the rate of short-term complications within one month of endoscopic PEG insertion, focusing on their correlation with patient characteristics.

Methodology: This retrospective cohort study analyzed data from patients who underwent PEG insertion between January 2020 and December 2022. It evaluated the incidence of complications in relation to variables such as the indication for the procedure, the patient's immune status, albumin and CRP levels, and the setting of the procedure (inpatient vs. outpatient).

Results: The study included 121 patients, with a mean age of 69.73 years, comprising 71 males (58.7%) and 50 females (41.3%). Neurological indications accounted for 64.5% of the cases. Notably, 67.8% of the patients were immunocompromised. Within 30 days of PEG insertion, 16.5% experienced complications, including GI bleeding (4.1%), infection at the PEG site (11.6%), and peritonitis (0.8%). Complications were significantly higher in immunocompromised patients and those with non-neurological indications. Higher serum albumin and lower CRP levels were associated with fewer complications, though the association was not statistically significant.

Conclusion: The study highlights that gastrostomy site infection is the most common short-term complication following PEG insertion. Immune status and the reason for PEG insertion emerged as key factors influencing the likelihood of complications.

Keywords: gastrostomy site infection; indication for gastrostomy; percutaneous endoscopic gastrostomy; percutaneous endoscopic gastrostomy (peg) feeding; percutaneous endoscopic gastrostomy complication; tube feeding.