PTU-011 Predicting outcome in patients deferred for percutaneous endoscopic gastrostomy: is the Levine score or the Sheffield gastrostomy score more accurate?: Abstract PTU-011

Abstract

<h3>Introduction</h3> Percutaneous endoscopic gastrostomy (PEG) insertion is widely accepted as the best means of providing medium and long-term enteral nutrition. There are limited data on outcomes in patients referred for gastrostomy insertion that are either refused or do not survive until PEG insertion. Scoring systems such as the Levine score have been created to try and predict survival rates over 1 year for any patients admitted acutely. We have also created a score to specifically predict mortality after gastrostomy insertion. These two scores have not been directly compared. The aim of this study was to identify which scoring system is the most useful for predicting survival after PEG. <h3>Methods</h3> All patients referred for PEG insertion in our institute are reviewed by the PEG nurse specialist and prospectively included in a database. Demographic, biochemical and outcome data are also included. PEG referrals from March 2007 to March 2009 were analysed and both the Levine score and the Sheffield gastrostomy score calculated. Mortality rates were then compared. <h3>Results</h3> During the study period 78 patients (mean age 69.5 years) were assessed for gastrostomy insertion but were turned down. Overall 30-day and 1 year mortality in this group was 33.3% and 73.1%, respectively. 1-year mortality as predicted by Levine score or Sheffield score is shown in Abstract 011. <h3>Conclusion</h3> The Sheffield score is more accurate at predicting 1-year mortality in patients deferred for gastrostomy insertion. This may suggest that the Sheffield PEG score could be used in the pre-assessment of patients who are being referred for PEG as a means of estimating/predicting mortality for those involved in the decision making process. Larger comparative studies are required to validate this finding.