JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Assessment of factors affecting mortality in patients with percutaneous endoscopic gastrostomy tube placement in the intensive care unit
Abstract
Aims: It was aimed to evaluate the clinical outcomes, complications, and factors affecting mortality of percutaneous endoscopic gastrostomy (PEG) applied to patients in the intensive care unit (ICU). Material and
Methods: PEG procedures which were performed in the ICU between January 2016 and January 2021 and patients' age, gender, comorbidities, trauma history, serum CRP, albumin levels, CRP albumin ratios (CAR), and PEG-related complications were reviewed. Patients were divided into two groups, patients without mortality (Group 1) and patients with mortality (Group 2), and a comparison between groups was made.
Results: Of all patients, 49 (39.2%) patients had mortality. The mean age of the patients in group 2 was 69.57±16.78 years, which was higher than the other group (p<0.001). Nephrological diseases and diabetes were significantly more common in Group 2, whereas neurologic diseases were less common (p=0.005, p=0.005, 0.044, respectively). The median length of stay (LOS) of the patients in Group 1 was 50 days, while the median LOS of the patients in Group 2 was found to be significantly higher, with 81 days (<0.001). The mean CRP of Group 2 was 81.63±54.06, which was higher than the other group, while the mean of albumin was found to be 2.29±0.5 and was lower than Group 1 (p<0.001, p<0.001). The mean CAR of Group 1 was 15.96±16.81, which was significantly lower than that of Group 2 (p<0.001). The optimal CAR cut-off value for mortality discrimination was found to be 20,216 with a sensitivity of 73.5%, a specificity of 78.9%, a positive predictive value of 69.2%, a negative predictive value of 82.2%, and 76.8% test accuracy. A CAR value of ? 20.216 increased the odds of death 9.3-fold (OR 10.385, CI 95% 4.481-24.065, p<0.001).
Conclusion: We suggest that CAR ratio, low albumin, and high CRP levels could be predictors of early mortality. Considering that PEG is an elective procedure, we believe that it can be a safe and effective procedure when nutritional support is provided by alternative means and appropriate conditions are met.

Keywords : Percutaneous endoscopic gastrostomy, complications, CRP/albumin ratio, mortality

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Article available in :
Volume 4, Issue 1, 2023
Page : 34-40
https://doi.org/10.47582/jompac.1217112
Article Information
Submitted : 10 Ara 2022
Accepted : 15 Oca 2023
Corresponding Author :

Ramazan Topçu: Department of General Surgery, Faculty of Medicine, Hitit University, Çorum, Turkiye

[email protected]
Citation : Topcu H, Sezikli İ, Tutan D, Köseoğlu H, Topcu R. Assessment of factors affecting mortality in patients with percutaneous endoscopic gastrostomy tube placement in the intensive care unit. J Med Palliat Care 2023; 4(1): 34-40.

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