Background And Aim: Percutaneous endoscopic gastrostomy (PEG) has been used in patients with dysphagia and inadequate food intake via an oral route. Despite being a procedure with a high success rate, complications and death have been reported. The aim was to identify the factors related to major complications and mortality, as well as PEG removal prognostic factors due to improvement of their general condition.
Methods: Patient characteristics, comorbidities, laboratory data, concomitant medication, sedation, and indication for PEG placement were collected. Major complications, mortality, and PEG removal factors were assessed.
Results: A total of 388 patients were enrolled. There were 15 (3.9%) cases of major complications, with major bleeding being the most frequent in 6 (1.5%) patients. Corticosteroids were the independent variable associated with major complications (odds ratio [OR] 5.85; 95% confidence interval [CI] 1.71-20; = <0.01). Advanced cancer (hazard ratio [HR] 0.5; 95% CI 0.3-1; = 0.05), albumin (HR 0.6; 95% CI 0.4-0.9; = <0.01), and C-reactive protein (CRP) (HR 1.1; CI 1-1.2; = 0.01) were considered risk factors for mortality. Previous pneumonia (HR 0.4; CI 0.2-0.9; = 0.02) was a factor for permanent use of a PEG; however, oncological indication (HR 8.2; CI 3.2-21; = <0.01) was factors for PEG withdrawal.
Conclusions: Chronic corticosteroid users potentially present with major complications. Low albumin levels and elevated CRP were associated with death. Previous aspiration pneumonia was a factor associated with permanent use of PEG; however, patients with oncological indication were the most benefited.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114989 | PMC |
http://dx.doi.org/10.1002/jgh3.12538 | DOI Listing |
Neurosurg Rev
January 2025
Department of neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Epilepsy is a common neurological disease that is treated with medications; however, patients with drug-resistant epilepsy, commonly intractable temporal lobe epilepsy, tend to have better control with surgical treatment. While the mainstay of surgical treatment is anterior temporal lobectomy, it carries risk of potential adverse effects hence minimally invasive techniques are now being used as an alternative to open surgery. This systematic review and meta-analysis compare the efficacy and safety of three of the most used techniques: laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and stereotactic radiosurgery (SRS).
View Article and Find Full Text PDFTech Coloproctol
January 2025
Peritonectomy and Liver Cancer Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia.
Background: The goal of cytoreductive surgery for peritoneal malignancy is to remove all macroscopic disease, which occasionally requires the excision of the umbilicus. While the absence of the umbilicus can be aesthetically undesirable for patients, umbilical reconstruction is rarely performed due to the perceived complexity and increased risk of wound infections (Sakata et al. in Colorectal Dis 23:1153-1157, 2021).
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Background: Traumatic brain injury (TBI) is considered a major cause of death globally, resulting from trauma. Decompressive craniectomy (DC) may improve functional outcomes in patients with TBI and its associated complications. This study was designed to determine safety and efficacy of DC in improving clinical outcomes in TBI patients compared to standard therapy.
View Article and Find Full Text PDFJ Glaucoma
January 2025
Department of Ophthalmology and Visual Sciences, University of British Colombia, Vancouver, BC.
Precis: Goniotomy is effective in managing intraocular pressure in childhood glaucoma secondary to uveitis with cumulative probability of success 0.94 after 1 year and 0.77 after 5 years.
View Article and Find Full Text PDFJ Wound Ostomy Continence Nurs
January 2025
Kyriaki Stefania Mitsaki, MBBCh, BSc (Hons), MSc, MRCP, Department of Dermatology, Northwick Park Hospital, London North West University Hospital NHS Trust, London, UK.
Background: Peristomal pyoderma gangrenosum (PPG) is a non-infectious neutrophilic dermatosis most commonly seen in the context of ostomies in inflammatory bowel disease. The lack of established treatment guidelines and high-quality evidence in the form of randomized controlled trials present a major challenge in PPG management, owing to the rarity of the condition. Treatment can be further complicated by difficulties in maintaining the stoma pouch seal with conventional topical corticosteroids.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!