Perkütan endoskopik gastrostomi’nin sağkalım sonuçları, serebrovasküler olay geçiren ve geçirmeyen kötü beslenen hastaların karşılaştırılması

Year 2019, , 796 - 799, 01.11.2019

Yaşar Küçükardalı Murat Hakan Terekeci Arzu Yalçın Rahman Nurmuhammedov Cengiz Pata Sibel Temür Ferda Fatma Kartufan Hakan Şilek Nazlı Şişik Yaltırık Elif Çiğdem Altunok

https://doi.org/10.28982/josam.581155

Abstract

Amaç: Yaşlı popülasyonda birden fazla hastalığın görülmesi gitgide artmaktadır. Bazı olgularda beslenme azlığı veya yokluğu acil durum yaratmaktadır. Bununla birlikte perkütan endoskopik gastrostominin (PEG), ciddi hastalıkları olan yaşlı hastalarda hayat kalitesi ve sağkalım oranına katkısı tartışmalıdır. 

Yöntemler: Bu prospektif kohort çalışmada, 2009-2015 yılları arasında PEG açılan hastalar 2 gruba bölündü: Bu gruplar, SVO grubu denen serebrovasküler olay (SVO) geçiren hastalar ve özofagus tümörü, baş ve boyun tümörleri, beyin tümörleri, amiyotrofik lateral skleroz ve terminal demansı olan hastalardan oluşan non-SVO grubunu kapsamaktadır. Bu çalışmada, hastaların PEG öncesi ve sonrası olmak üzere vücut kitle indexi(VKİ) değerleri, hemoglobin (Hb), albümin (alb), kreatinin (Kr), C-reaktif protein (CRP), lökosit, demografik özellikleri, 30, 90, 180 ve 365 günlük sağkalım oranları, mekanik, metabolik ve infeksiyöz komplikasyonları PEG varlığı boyunca karşılaştırıldı.

Bulgular: SVO’lu olgularda ortalama yaş grubu düşük olanlarda 90. Gündeki sağkalım oranı daha yüksekti. Diğer parametrelerde belirgin bir fark yoktu. 1 yılın sonunda SVO’lu olguların % 21’i PEG’siz beslenebilirken, bu oran non-SVO’lu olgularda %12 olarak saptandı.

Sonuç: PEG’le beslenme 3 aylık izlemde SVO’lu olgularda daha yüksek oranda bulunurken; 1 yıllık ve total izlemde her iki grup arasında anlamlı farklılık bulunmadı.

Keywords

Serebrovasküler olay, Enteral beslenme, Perkütan endoskopik gastrostomi

Survival outcomes of percutaneous endoscopic gastrostomy, comparison of cerebrovascular event and non-cerebrovascular event in malnourished patients

Abstract

Aim: The number of comorbid diseases increased with the rise in the elderly population. In some cases, the state of deficient or absent nutrition emerges. Nevertheless, the contribution of percutaneous endoscopic gastrostomy (PEG) to the quality of life and the survival rate in the elderly with certain diseases remains controversial. 

Methods: In this prospective cohort study, patients who underwent percutaneous endoscopic gastrostomy (PEG) procedure between 2009 and 2015 were divided into two groups: CVE group consisted of patients with cerebrovascular event (CVE) and non-CVE group comprised patients who suffered from esophageal tumors, head and neck tumors, brain tumors, amyotrophic lateral sclerosis and terminal dementia. In this study, the patients' pre-PEG and post-PEG body mass index (BMI) values, hemoglobin (Hb), albumin (alb), creatinine (Cr) and C-reactive protein (CRP) values, white blood cell counts, demographic characteristics, 30, 90, 180 and 365 day-survival rates, complications (mechanical, metabolic and infectious) and duration of patency of the PEGs were compared.

Results: The average age was lower while survival rate on the 90th day was higher in the CVE group. No significant difference was found in terms of other parameters. At the end of the one-year follow-up, 21% of the patients in the CVE group and 12% of those in the non-CVE group were able to be fed without PEG. 

Conclusion: PEG patency was higher in the CVE group at 3 months but there was no statistically significant difference between the groups at one-year and overall follow-up periods.

Keywords

Cerebrovascular events, Enteral nutrition, Percutaneous endoscopic gastrostomy

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