Albumin and C-reactive protein levels predict short-term mortality after percutaneous endoscopic gastrostomy in a prospective cohort study
ABSTRACT 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.
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.
Prospective cohort study from 2005 to 2009. Follow-up 14 days after PEG.
This study involved 484 patients referred for PEG.
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.
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).
Missing data in some study variables. Although the sample size was large, weaker associations could not be established.
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.
- SourceAvailable from: Akira Horiuchi[Show abstract] [Hide abstract]
ABSTRACT: Background: To examine the effects of percutaneous endoscopic gastrostomy (PEG) on quality of life (QOL) in patients with de-mentia.
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ABSTRACT: Percutaneous endoscopy gastrostomy (PEG) tubes are a valuable tool for providing long-term enteral nutrition or gastric decompression; certain circumstances that complicate PEG placement warrant novel approaches and merit review and discussion. Ascites and portal hypertension with varices have been associated with poorer outcomes. Bleeding is one of the most common serious complications affecting approximately 2.5% of all procedures. This article will review what evidence exists in these high risk scenarios and attempt to provide more clarity when considering these challenging clinical circumstances.
Conference Paper: Numerical mode matching method with perfectly matching layer[Show abstract] [Hide abstract]
ABSTRACT: The numerical mode matching method (NMM) with the perfectly matching layer (PML) has been presented in this paper to solve electromagnetic fields in stratified media with some possible lossless layers. When the 2D inhomogeneous media is lossy media, the field in this inhomogeneous media can be solved efficiently by using the NMM with the concepts of the general reflection matrix and general transmission matrix. Unfortunately, this method failed in the case of lossless media. In order to make the NMM available in the media with lossless layers, the PML has been introduced into the NMM in this paper to build the truncated absorbing boundary in lossless layers. Some numerical examples have also been given in this paper.Antennas and Propagation Society International Symposium, 2005 IEEE; 08/2005