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How long do percutaneous endoscopic gastrostomy feeding tubes last? A retrospective analysis
  1. Keith Siau1,2,
  2. Tom Troth1,
  3. Elizabeth Gibson3,
  4. Anita Dhanda3,
  5. Lauren Robinson3,
  6. Neil C Fisher1
  1. 1 Department of Gastroenterology, Dudley Group NHS Foundation Trust, Dudley, UK
  2. 2 Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
  3. 3 Dudley Group NHS Foundation Trust, Dudley, UK
  1. Correspondence to Dr Neil C Fisher, Department of Gastroenterology, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, UK; neil.fisher1{at}nhs.net

Abstract

Background Percutaneous endoscopic gastrostomy (PEG) tubes allow for long-term enteral feeding. Disk-retained PEG tubes may be suitable for long-term usage without planned replacement, but data on longevity are limited. We aimed to assess the rates and predictors of PEG longevity and post-PEG mortality.

Design Single-centred retrospective cohort study of patients with disk-retained (Freka) PEG tubes.

Methods All patients undergoing PEG between 2010 and 2013 were identified, and retrospective analysis of outcomes until 2017 (median 1062 days) was performed. Time-to-event data were plotted using Kaplan-Meier curves, with predictors of survival derived from multivariate Cox-regression analyses.

Results 277patients were studied, with a median age of 74 years (IQR 59–82). PEG tube failure occurred in 17.4%, due to: buried bumper syndrome (7.0%), split/broken tube (6.3%), peristomal infection (1.8%) and dislodged tube (1.1%). PEG tube longevity was 95.1% (1 year) and 68.5% (5 year), with age <70 (HR 2.65, 95% CI 1.25 to 5.62, p=0.011) being predictive of PEG failure. Post-PEG mortality was 10.5% (30 day), 35.4% (1 year) and 59.7% (5 year). Age ≥70 was associated with mortality (HR 2.79, 95% CI 1.92 to 4.05, p<0.001), whereas PEG failure (HR 0.46, 95% CI 0.27 to 0.77, p=0.003) and elective PEG removal (HR 0.23, 95% CI 0.08 to 0.64, p=0.005) were associated with reduced mortality.

Conclusions 68.5% of PEG tubes remain intact after 5 years. Younger age was associated with earlier PEG failure, whereas younger age, PEG replacement and elective PEG tube removal were associated with improved survival. These data may inform future guidance for elective PEG tube replacements.

  • nutritional support
  • endoscopy

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Footnotes

  • Contributors KS: performed the statistical analyses and produced the original draft. TT, EG, AD, LR: performed data collection and the literature review. NCF: conceived the original project, provided analytical oversight, and enhanced the quality of the manuscript. All authors edited and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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