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Ahmad MB, Ansar F, Shakoor K, Adnan M, Naqi SA, Tahir Z, Rauf MS, Bin Shafaat Chaudhary U, Alamgir A, Aslam N. Compliance With Percutaneous Endoscopic Gastrostomy Tube Insertion Guidelines and Associated Complications in a Tertiary Care Setting: A Clinical Audit. Cureus 2023; 15:e43566. [PMID: 37719490 PMCID: PMC10503224 DOI: 10.7759/cureus.43566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Percutaneous endoscopic gastrostomy (PEG) tube insertion is a widely utilized enteral access technique offering long-term nutritional support for patients unable to tolerate oral intake. While the PEG tube provides numerous advantages, adherence to evidence-based guidelines is crucial to minimize complications. This study aims to evaluate adherence to PEG tube insertion guidelines and analyze associated complication rates in a tertiary care setting. METHODS A retrospective clinical audit was conducted at Quaid-e-Azam International Hospital, Islamabad. Data were collected over three years from patients undergoing PEG tube insertion by a single consultant gastrointestinal surgeon. Adherence to guidelines was evaluated using a 10-item checklist developed based on European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Complication rates and patient characteristics were analyzed. RESULTS The study included 70 participants (mean age = 72.21 ± 13.17). The PEG tube insertion rate was 100%. The mean checklist score was 8.34 ± 1.2. Laboratory investigations were performed for 98.6% of patients. 91.4% of patients had a life expectancy exceeding 30 days. 60% of patients received an anticoagulation hold. Prophylactic antibiotics were administered to 90% of patients. Psychological counseling and dietician consultation were offered to 38.6% and 64.2% of patients, respectively. Caregivers received specialized training in 98.5% of cases. 12.8% of patients experienced early complications post-procedure, and 14.2% experienced late complications. PEG tube removal occurred in 27% of patients, with only one patient experiencing complications after removal. CONCLUSION Adherence to PEG tube insertion guidelines was observed in various aspects of patient care, resulting in a low incidence of complications. Comprehensive auditing and guideline adherence are essential to ensure optimal patient safety and procedural outcomes.
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Affiliation(s)
| | - Farrukh Ansar
- Medicine, Quaid-e-Azam International Hospital, Islamabad, PAK
| | - Kainaat Shakoor
- Medicine, Quaid-e-Azam International Hospital, Islamabad, PAK
| | - Muhammad Adnan
- Medicine, Quaid-e-Azam International Hospital, Islamabad, PAK
| | - Syed Ali Naqi
- Surgery, Quaid-e-Azam International Hospital, Islamabad, PAK
| | - Zainab Tahir
- Surgery, Quaid-e-Azam International Hospital, Islamabad, PAK
| | - Mohammad S Rauf
- Medicine and Surgery, Northwest General Hospital, Peshawar, PAK
| | | | - Asad Alamgir
- Internal Medicine, Fauji Foundation Hospital Rawalpindi, Islamabad, PAK
| | - Nabiha Aslam
- Surgery, Quaid-e-Azam International Hospital, Islamabad, PAK
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Jung SO, Moon HS, Kim TH, Park JH, Kim JS, Kang SH, Sung JK, Jeong HY. Nutritional Impact of Percutaneous Endoscopic Gastrostomy: A Retrospective Single-center Study. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2022; 79:12-21. [PMID: 35086968 DOI: 10.4166/kjg.2021.086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/02/2021] [Accepted: 11/01/2021] [Indexed: 11/03/2022]
Abstract
Background/Aims Several conditions may cause difficulties with oral feeding. Percutaneous endoscopic gastrostomy (PEG) is commonly performed on patients who require enteral feeding for >2-3 weeks. This study examined the nutritional state of patients who required enteral feeding and underwent PEG to quantify the benefits of the procedure. Methods This retrospective study included patients who underwent PEG at the Chungnam National University Hospital between January 2013 and December 2018. A gastroenterologist performed all PEG procedures using the pull technique, and all patients were followed up for >3 weeks postoperatively. The BMI and lymphocyte count, along with the levels of hemoglobin, total protein, albumin, total cholesterol, BUN, and creatinine pre-PEG and between 3 weeks and 6 months post-PEG were evaluated. Results Overall, 151 patients (116 males; mean age 64.92 years) were evaluated. Of these patients, 112 (74.2%), 34 (22.5%), and five (3.3%) underwent PEG tube insertion because of neurological diseases, malignancy, and other conditions, respectively. The BMI and the hemoglobin, total protein, albumin, and total cholesterol levels were significantly higher post-PEG than pre-PEG. Conclusions These findings highlight the usefulness of PEG in the management of nutritionally poor patients with difficulties in feeding orally.
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Affiliation(s)
- Sang Ok Jung
- Division of Gastroenterology, Department of Internal Medicine, Daejeon Veterans Hospital, Daejeon, Korea
| | - Hee Seok Moon
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Tae Hyung Kim
- Division of Disaster Statistics, Department of Fire and Disaster Prevention, Daejeon University, Daejeon, Korea
| | - Jae Ho Park
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Ju Seok Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Sun Hyung Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jae Kyu Sung
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hyun Yong Jeong
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.,Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
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