Sa1259 HIGH BLOOD UREA NITROGEN LEVEL CAN BE A PREDICTIVE CLINICAL FACTOR FOR EARLY DEATH AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY.

Abstract

Percutaneous endoscopic gastrostomy (PEG) is accepted as a method for administering enteral feeding to patients with swallowing difficulties. However, the prevalence of complications and early death after PEG is considerably high. To decrease the incidence of early mortality after PEG, it is very important to identify risk factors for early death after PEG. The aim of our study was to determine factors that could predict early death within 30 days following PEG. We retrospectively analyzed the records of all patients who underwent PEG at Kure Medical Center and Chugoku Cancer Center from April 2008 to July 2017. We examined clinical and preoperative laboratory data and extracted data of predictive factors for early death after PEG by using univariate and multivariate analyses. A total of 993 patients—459 female (46.2%) and 534 male (53.8%) patients with a mean age of 78 years—were assessed. Predictors of poor survival after PEG included age ≥81 years (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.1–3.2; P<0.01), white blood cell count ≥9000/μL (OR, 1.91; 95% CI, 1.2–3.1; P<0.005), L-lactate dehydrogenase level ≥300 U/L (OR, 2.51; 95% CI, 1.5–4.3; P<0.005), blood urea nitrogen level ≥34 mg/dL (OR, 2.75; 95% CI, 1.6–4.8; P<0.001), C-reactive protein level ≥2.6 mg/dL (OR 2.72; 95% CI, 1.6–4.4; P<0.001), total protein level ≤5.8 mg/dL (OR, 2.4; 95% CI, 1.3–4.4; P<0.05), albumin level ≤2.7 mg/dL (OR, 3.2; 95% CI, 1.7–6.1; P<0.005), hemoglobin level ≤9.4 g/dL (OR, 2.6; 95% CI, 1.5–4.2; P<0.001), and cholinesterase level ≤172 IU/L (OR, 7.2; 95% CI, 1.6–32; P<0.05). Multivariate analysis on predictive factors for early death revealed high blood urea nitrogen level (OR, 5.45; 95% CI, 1.7–16.9; P<0.05) as an independent risk factor. High blood urea nitrogen level may be a useful predictive clinical factor for early death after PEG. If patients have a history of high blood urea nitrogen levels, PEG should be considered carefully.