Safety of percutaneous endoscopic gastrostomy in older patients with amyotrophic lateral sclerosis
10.3760/cma.j.issn.0254-9026.2025.01.007
- VernacularTitle:经皮内镜下胃造瘘术在老年肌萎缩侧索硬化症患者中应用的安全性分析
- Author:
Wenzheng LIU
1
;
Yuhuan MA
;
Xiu'e YAN
;
Hong CHANG
;
Wei YAO
;
Yingchun WANG
;
Wei ZHENG
;
Yaopeng ZHANG
;
Yonghui HUANG
Author Information
1. 北京大学第三医院 消化科，北京 100191
- Publication Type:Journal Article
- Keywords:
Percutaneous endoscopic gastrostomy;
Amyotrophic lateral sclerosis;
The elderly;
Aspiration pneumonia
- From:
Chinese Journal of Geriatrics
2025;44(1):40-45
- CountryChina
- Language:Chinese
-
Abstract:
Objective:A retrospective study was conducted to investigate the safety of Percutaneous Endoscopic Gastrostomy(PEG)in elderly patients with Amyotrophic Lateral Sclerosis(ALS)and to identify the factors influencing major complications.The aim is to establish a more robust foundation for optimizing both the procedure and its timing, thereby enhancing the evidence base for refining the surgical approach.Methods:We retrospectively collected clinical data from elderly ALS patients(≥60 years old)who underwent PEG at Peking University Third Hospital between January 2006 and January 2024.This dataset includes information on general health conditions, the progression of ALS, comorbidities, surgical details, and related complications.Additionally, we analyzed the postoperative complications experienced by the included patients, focusing specifically on the risk factors associated with aspiration pneumonia.Results:A total of 140 patients were included in the study, with a mean age of 68.2±5.9 years.Among these, 69 were male(49.3%)with a mean age of 68.4±6.5 years, and 71 were female(50.7%)with a mean age of 67.7±6.0 years.Successful outcomes were observed in 139 cases(99.3%).One case was not completed due to respiratory arrest caused by intraoperative aspiration.Postoperative complications occurred in 36 cases(25.7%), which included 9 cases of wound infection(6.4%), 1 case of abdominal infection(0.7%), 21 cases of aspiration pneumonia(15.0%), 1 case of local fistula leakage(0.7%), 2 cases of transient fever(1.4%), and 2 cases of death during hospitalization(1.4%).Both univariate and multivariate analyses indicated that an onset duration of ≤1 year( P=0.020)and a half-sitting position( P=0.022)significantly influenced the occurrence of aspiration pneumonia, acting as protective factors( β<0, OR<1). Conclusions:PEG is a safe method for providing enteral nutrition to elderly patients with ALS.While most complications associated with the procedure are mild and can be managed, Aspiration pneumonia remains a common and serious complication.However, early surgical intervention and the use of a semi-seated position during the procedure can help reduce the incidence of aspiration pneumonia.
