Perkütan Endoskopik Gastrostomi Takılan Hastaların Uzun Dönem Takip Sonuçları ve Sağkalımı Etkileyen Faktörler

Year 2019, Volume: 72 Issue: 2, 179 - 183, 02.10.2019

Evrim Kahramanoğlu Aksoy

https://doi.org/10.4274/atfm.galenos.2019.36854

Abstract

Objectives: Percutaneous endoscopic gastrostomy (PEG) is a minimally invasive procedure with well-known efficacy and safety that is frequently used in
patients who cannot be fed orally. In the literature, studies investigating long-term follow-up results in patients undergoing PEG are limited. In this study,
we aimed to determine the long-term follow-up results and the factors affecting mortality in patients undergoing PEG.

Materials and Methods: Two hundred and three patients who underwent PEG placement between January 2013 and June 2018 were evaluated
retrospectively. The demographic characteristics of the patients, postoperative follow-up times, complications, PEG indications, laboratory parameters
during the procedure were recorded from the patient files. During the follow-up period, the mortality and time of the patients were determined via the
death notification system.

Results: A total of 203 patients (101 male, 102 female) were included in the study. The median age of the patients was 77 years (18-96). The most frequent
PEG placement indication was stroke with a frequency of 34%, followed by dementia (28.6%), malignancy (10.8%) and other (15.8%) reasons. The median
follow-up period was 33.6 months (30.5-36.7) and the median survival was 22 months [95% confidence interval (CI): 22.8-30.5]. Mortality rates were 1.5%
in the first month, 3% in 3 months, 12.3% in 1 year, 26.6 years in 2 years, 34.5% in 3 years and 44.3% in 5 years. There was no correlation between PEG
indications and mortality, but there was a statistically significant correlation between hyponatremia and mortality (Odds ratio: 1.07, p=0.027, %95 CI).

Conclusion: There was no statistically significant relationship between PEG placement indications and mortality, but there was a statistically significant
correlation between hyponatremia and mortality.

Keywords

Percutaneous Endoscopic Gastrostomy , Mortality , Follow-up Results

Perkütan Endoskopik Gastrostomi Takılan Hastaların Uzun Dönem Takip Sonuçları ve Sağkalımı Etkileyen Faktörler

Abstract

Amaç: Perkütan endoskopik gastrostomi (PEG), etkinlik ve güvenilirliği iyi bilinen, oral beslenemeyen hastalarda sıklıkla uygulanan minimal invaziv
bir yöntemdir. Literatürde PEG uygulanan hastalarda uzun dönem takip sonuçlarını inceleyen çalışmalar kısıtlıdır. Biz bu çalışmada PEG uygulanan
hastalarda uzun dönem takip sonuçlarını ve mortaliteyi etkileyen faktörleri ortaya koymayı amaçladık.

Gereç ve Yöntem: Ocak 2013-Haziran 2018 tarihleri arasında PEG takılan 203 hasta retrospektif olarak değerlendirildi. Hastaların demografik
özellikleri, işlem sonrası takip süreleri, varsa komplikasyonları, PEG endikasyonları, işlem sırasındaki laboratuvar parametreleri hasta dosyalarından
kaydedildi. Takip süreleri boyunca hastalarda mortalite oluşumu ve zamanı, ölüm bildirim sistemi üzerinden tespit edildi.

Bulgular: Çalışmaya toplam 203 hasta (101 erkek, 102 kadın) dahil edildi. Hastaların ortanca yaşları 77 idi (18-96). En sık PEG endikasyonu %34
sıklıkta inme olarak gözlenirken bunu demans (%28,6), malignite (%10,8) ve diğer (%15,8) nedenler takip etti. Ortanca takip süresi 33,6 ay (30,5-
36,7), ortanca sağkalım süresi 22 ay [%95 güven aralığı (CI): 22,8-30,5] olarak tespit edildi. Hastaların mortalite oranları ilk 1 ayda %1,5, 3 ayda %3,
1 yılda %12,3, 2 yılda 26,6, 3 yılda %34,5, 5 yılda %44,3 olarak bulundu. PEG endikasyonları mortalite arasında ilişki saptanmazken hiponatremi ile
mortalite arasında istatistiksel olarak anlamlı bir ilişki saptandı (olasılık oranı: 1,07; p=0,027; %95 CI).

Sonuç: PEG endikasyonları mortalite arasında ilişki saptanmazken hiponatremi ile mortalite arasında istatistiksel olarak anlamlı bir ilişki saptandı

Keywords

Perkütan Endoskopik Gastrostomi , Mortalite , Takip Sonuçları

Ethical Statement

Etik Etik Kurul Onayı: Çalışma retrospektif olduğu için etik kurul onayı alınmamıştır. Sağlık Bilimleri Üniversitesi Ankara Keçiören Eğitim ve Araştırma Hastanesi Sağlık Uygulama Araştırma Merkezi Tıpta Uzmanlık Eğitimi Kurul kararı mevcuttur (43278876-929-618-5247). Hasta Onayı: Çalışma retrospektif olduğu için hasta onayı alınmamıştır. Hakem Değerlendirmesi: Editörler kurulu dışında olan kişiler tarafından değerlendirilmiştir.

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