Document Detail


Investigation and prediction of enteral nutrition problems after percutaneous endoscopic gastrostomy.
MedLine Citation:
PMID:  19294767     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To investigate and predict enteral nutrition problems after percutaneous endoscopic gastrostomy (PEG). METHODS: We retrospectively analyzed data for 252 out of 285 patients who underwent PEG at our hospital from 1999 to 2008. Enteral nutrition problems after PEG were defined as: (1) patients who required > or = 1 mo after surgery to switch to complete enteral nutrition, or who required additional parenteral alimentation continuously; or (2) patients who abandoned switching to enteral nutrition using the gastrostoma and employed other nutritional methods. We attempted to identify the predictors of problem cases by using a logistic regression analysis that examined the patients' backgrounds and the specific causes that led to their problems. RESULTS: Mean age of the patients was 75 years, and in general, their body weight was low and their overall condition was markedly poor. Blood testing revealed that patients tended to be anemic and malnourished. A total of 44 patients (17.5%) were diagnosed as having enteral nutrition problems after PEG. Major causes of the problems included pneumonia, acute enterocolitis (often Clostridium difficile-related), paralytic ileus and biliary tract infection. A multivariate analysis identified the following independent predictors for problem cases: (1) enteral nutrition before gastrectomy (a risk reduction factor); (2) presence of esophageal hiatal hernia; (3) past history of paralytic ileus; and (4) presence of chronic renal dysfunction. CONCLUSION: Enteral nutrition problems after PEG occurred at a comparatively high rate. Patient background analysis elucidated four predictive factors for the problem cases.
Authors:
Shiro Yokohama; Masaru Aoshima; Yukiomi Nakade; Junya Shindo; Junichi Maruyama; Masashi Yoneda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  15     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-18     Completed Date:  2009-05-20     Revised Date:  2010-09-23    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  1367-72     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Asahikawa Rehabilitation Hospital, Midorigaoka Higashi 1-1-1-1, Asahikawa 078-8801, Japan. s44yokohama11@reha.or.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anemia / epidemiology
Anti-Bacterial Agents / therapeutic use
Blood Glucose / analysis
C-Reactive Protein / analysis
Enteral Nutrition / adverse effects,  methods*
Enterocolitis / epidemiology
Female
Gastrectomy
Gastrostomy / adverse effects*,  methods
Humans
Intestinal Pseudo-Obstruction / epidemiology
Intubation, Gastrointestinal / methods
Male
Malnutrition / epidemiology
Middle Aged
Parenteral Nutrition
Pneumonia, Aspiration / epidemiology
Predictive Value of Tests
Retrospective Studies
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Blood Glucose; 9007-41-4/C-Reactive Protein
Comments/Corrections

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