Abstract
Background/ObjectivesThis historical control study examined the differences in the incidence of postoperative pneumonia between patients administered liquid and semi-solid nutrients after percutaneous endoscopic gastrostomy (PEG).Subjects/MethodsThe medical records of adult patients who underwent PEG between March 1999 and March 2014 were investigated. The patients were administered either liquid or semi-solid nutrient and examined for gastroesophageal reflux via radiography after PEG. The study period was divided into periods I (liquid nutrient to all patients), II (semi-solid nutrient to patients with reflux and liquid nutrient to those without), and III (semi-solid nutrient to all patients). The patient characteristics and incidence of postoperative pneumonia were stratified by the periods. To assess the relationship between postoperative pneumonia and the periods, a logistic regression analysis was performed.ResultsOf 370 patients enrolled, 149 were in period I, 64 in period II, and 157 in period III. Postoperative pneumonia was more frequently observed in period I (20.8%) than in periods II (7.8%) and III (10.2%). The odds ratios were higher in period I (period I vs. II: 3.10 [95% confidence intervals: 1.15–8.38]; period I vs. III: 2.32 [1.21–4.44]). The incidence of gastroesophageal reflux did not greatly differ between periods II (25.0%) and III (35.0%).ConclusionsThe incidence of postoperative pneumonia after PEG was lower in the patients administered semi-solid nutrient than in those administered liquid nutrient, suggesting that semi-solid nutrient administration to patients with PEG tubes is preferable to prevent postoperative pneumonia. Furthermore, it may be favored especially in those with gastroesophageal reflux.
Highlights
Supplementary information The online version of this article contains supplementary material, which is available to authorized users
Percutaneous endoscopic gastrostomy (PEG) is considered a useful method of feeding patients with impaired oral intake resulting from disorders, including cerebrovascular accident
percutaneous endoscopic gastrostomy (PEG) is related to the risk of common complications, such as peristomal infection, and major severe complications, such as aspiration pneumonia, bleeding, buried bumper syndrome, and bowel perforation [4,5,6]
Summary
Percutaneous endoscopic gastrostomy (PEG) is considered a useful method of feeding patients with impaired oral intake resulting from disorders, including cerebrovascular accident. The guidelines on enteral nutrition recommend the use of PEG for physiological management of the nutrition for such patients [1,2,3]. PEG is related to the risk of common complications, such as peristomal infection, and major severe complications, such as aspiration pneumonia, bleeding, buried bumper syndrome, and bowel perforation [4,5,6]. Pneumonia mainly caused by aspiration after PEG can be fatal [7,8,9]. Up to 50 % of postoperative early mortality within 30 days after PEG was attributable to aspiration pneumonia [8, 9]
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