Læknablaðið - 15.02.2012, Page 30

RANNSOKN
ENGLISH SUMMARY
Percutaneous endoscopic gastrostomy in lceland over 10 year period
A retrospective study of indications, complications and ethical issues
Birgisson S
Objective: Percutaneous endoscopic gastrostomy (PEG) is the preferred
method for long term enteral feeding. No nationwide study has reported
on the experience and outcome of PEG procedure. The aim of this study
was to describe the frequency, indications, complications, mortality and
ethical issues related to PEG procedures in lceland.
Material and methods: A retrospective study was performed on all
adult patients who had PEG procedures in lceland between 2000-2009.
Medical charts from patients found were reviewed and data regarding
demographics, indications, complications, mortality and ethically contro-
versial cases was obtained.
Results: A total of 278 patients had PEG procedures during the 10
year study period. There were 163 men and 115 women with a median
age of 70 years. The mean annual incidence of PEG procedures was
12.8/100.000. Sufficient medical data for evaluation was obtained from
263 patients. The most common indications were neurological disorders
(61%) and malignancies (13%). Dementia accounted for only 0.8% of the
indications. Total complication rate was 6.5% with 1.9% being major
and 4.6% minor complications. Peritonitis was the most common (2.7%)
complication followed by peristomal skin infection (1.9%). Operative
mortality was 0.8% and 30 day mortality rate was 13%. In seven (2.7%)
cases the PEG procedure was considered to be ethically and medically
controversial.
Conclusion: This is the first published nationwide study on the experi-
ence of PEG procedures. The complication and mortality rates in lceland
are among the lowest reported. The indications reported here are in
agreement with national guidelines with the rate of PEG procedures in
ethically controversial cases being very rare.
Key words: Percutaneous endoscopic gastrostomy, indications, complications, ethics.
Correspondence: Sigurbjörn Birgisson, sigurbj@tandspitati.is
Internal medicine, University Hospital Landspitaii.
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