Abstract No. 592 Early (

Abstract

To report placement parameters, feeding protocols, and adverse events for inpatients undergoing initiation of early (<12 hours) enteral nutrition following primary percutaneous ≥16-French gastrostomy placements. Such practices have been reported in outpatient oncology patients and after endoscopic gastrostomy placements, but not regarding inpatient placements by interventional radiology. A total of 2573 encounters containing “gastrostomy placement” were screened between 2015 and 2019. 236 inpatients, including 148 (62.7%) males and 88 (37.3%) females with mean age 59.4 ± 17.4 years, underwent early (<12 hour) enteral nutrition via ≥16-French gastrostomy tubes. Indications for placement included: neurologic (n = 159; 67.4%), malignancy (n = 50; 21.2%), miscellaneous (n = 23; 9.7%), and malnutrition (n = 4; 1.7%). Tubes were cleared for use 4 hours after placement. Placement parameters, immediate (intraprocedural) adverse events, early nutrition protocols, 30-day adverse events, and mortality were recorded. Most interventions were performed using 3 gastropexy sutures (n = 231; 98.9%) and a 16-French gastrostomy tube (n = 180; 76.3%). Pigtail and balloon-type gastrostomy tubes were placed in 156 (66.1%) and 98 (41.5%) patients, respectively. Immediate adverse events occurred in 2 (0.8%) patients, including broken gastropexy sutures without (category A; minor) and with arterial injury requiring embolization (category D; major). Mean time to enteral nutrition initiation was 7.5 ± 3.0 hours with mean rate of 104 ± 150 mL/hour. There were 14 (5.9%) adverse events within 30 days, including 3 category A (minor), 7 category B (minor), 3 category D (major), and 1 category F (major) complications. There were no differences in gastrostomy size (P = 0.45), tube type (P = 0.93), mean time to enteral nutrition initiation (P = 0.58), or mean initial tube feed rate (P = 0.09) between those without and with 30-day adverse events. Early (<12 hours) enteral nutrition after percutaneous large-bore (≥16-French) gastrostomy placement is safe in inpatients with adverse events within previously reported standards (0.4-22.5%).