Early mortality and adverse health outcomes after percutaneous endoscopic gastrostomy placement in palliative care patients
Öz
Purpose: Percutaneous endoscopic gastrostomy (PEG) is performed in patients unable to feed by mouth. In this study, we aimed to compare early mortality and adverse health outcomes between stroke patients and non-stroke patients who underwent PEG placement while receiving palliative care. Materials and Methods: The study included patients who were admitted to the palliative care unit between March 2022 and September 2023 and had undergone PEG within the three months preceding their admission. Patient records were reviewed retrospectively. Patients’ sex, age, Charlson Comorbidity Index, tracheostomy status, pressure injuries, readmission rates, and mortality rates within 30 days after discharge who underwent PEG placement were obtained. Results: The study included 34 stroke patients and 54 non-stroke patients. The stroke patients had a higher mean Charlson Comorbidity Index of 6.08±1.48 compared to the non-stroke patients, whose mean Charlson Comorbidity Index was 3.01±2.42. The length of hospitalization was 60.47 ± 24.27 days in stroke patients and 86.26 ± 63.02 days in non-stroke patients. Tracheostomy was present in 26.5% of stroke patients, compared with 66.7% of non-stroke patients. Thus, non-stroke patients experienced statistically significant longer hospital stays and a higher frequency of tracheostomy. Among all patients, the rate of early healthcare admission was 45.5%, and the overall mortality was 23.9%. Readmission rates, mortality, and complications related to PEG placement were similar between the two groups. The frequency of PEG-related complications was 8.8% in the stroke group and 3.7% in the non-stroke group. The 30-day post-discharge mortality rate was 29.4% in the stroke group and 20.4% in the non-stroke group. Mortality was significantly associated with age (OR:1.05, 95% CI:1.01-1.08) and Charlson Comorbidity Index (OR: 1.42, 95% CI: 1.12-1.79). Conclusion: Mortality and early readmissions to the hospital were frequent in palliative care patients receiving enteral nutrition. In palliative care settings, accurately identifying individuals for planning enteral nutrition programs is crucial.
Anahtar Kelimeler
Gastrostomy, Stroke, Enteral nutrition, Mortality, Palliative care, Complication
Kaynakça
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