Albumin and C-reactive protein levels predict short-term mortality after percutaneous endoscopic gastrostomy in a prospective cohort study.

Abstract:

BACKGROUND:Percutaneous endoscopic gastrostomy (PEG) is a procedure with many complications that sometimes can be devastating. To give better advice to patients referred for PEG regarding risk of complications, important risk factors should be known. OBJECTIVE:To evaluate whether age, body mass index, albumin levels, C-reactive protein (CRP) levels, indication for PEG, and comorbidity influence the risk of mortality or peristomal infection after PEG insertion. DESIGN:Prospective cohort study from 2005 to 2009. Follow-up 14 days after PEG. SETTING:University hospital. PATIENTS:This study involved 484 patients referred for PEG. INTERVENTION:PEG. MAIN OUTCOME MEASUREMENTS:Mortality within 30 days and peristomal infection within 14 days after PEG insertion. All risk estimates were calculated with 95% CIs and adjusted for confounding. RESULTS:Among 484 patients, 58 (12%) died within 30 days after PEG insertion. Albumin <30 g/L (hazard ratio [HR], 3.46; 95% CI, 1.75-6.88), CRP ≥10 (HR, 3.47; 95% CI, 1.68-7.18), age ≥65 years (HR, 2.26; 95% CI, 1.20-4.25) and possibly body mass index <18.5 (HR, 2.04; 95% CI, 0.97-4.31) were associated with increased mortality. Patients with a combination of low albumin and high CRP levels had a mortality rate of 20.5% compared with 2.6% among patients with normal values, rendering an over 7-fold increased adjusted risk of mortality (HR, 7.45; 95% CI, 2.62-21.19). LIMITATIONS:Missing data in some study variables. Although the sample size was large, weaker associations could not be established. CONCLUSION:The combination of low albumin and high CRP levels indicates a substantially increased short-term mortality risk after PEG, which should be considered in decision making.

journal_name

Gastrointest Endosc

authors

Blomberg J,Lagergren P,Martin L,Mattsson F,Lagergren J

doi

10.1016/j.gie.2010.09.012

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

29-36

issue

1

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(10)02094-8

journal_volume

73

pub_type

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