TY - JOUR
T1 - Contemporary acute care surgery percutaneous endoscopic gastrostomy tube placement
T2 - An extreme bumper height and complications
AU - Glazer, Evan S.
AU - Kulvatunyou, Narong
AU - Green, Donald J.
AU - Gries, Lynn
AU - Joseph, Bellal
AU - O'Keeffe, Terence
AU - Tang, Andrew L.
AU - Wynne, Julie L.
AU - Friese, Randall S.
AU - Rhee, Peter M.
PY - 2013/11
Y1 - 2013/11
N2 - BACKGROUND: As the role of acute care surgery (ACS) becomes more prevalent, clinicians in this specialty will be placing more percutaneous endoscopic gastrostomy (PEG) tubes. In this contemporary series of ACS PEG procedures, we hypothesized that technical aspects of PEG tube placement may play an important role. METHODS: For our retrospective study, we queried our tertiary Level I trauma center's prospectively maintained ACS database for PEG tube placement. Our study period was from July 1, 2010, through June 30, 2012.We excluded patients who underwent "push" PEG placement, an outpatient PEG tube placement, or an open or laparoscopic gastrostomy tube operation. We conducted a multivariate logistic regression analysis of factors contributing to complications. RESULTS: During our 24-month study period, of 184 patients, 133 underwent "pull" PEG tube placement with sufficient data for analysis. The mean (SD) agewas 56 (22) years; 66%were male. Overall, 33 (25%) experienced complications: 13 (10%) were major and 20 (15%) were minor complications. In our multivariate logistic regression analysis, we found that an extreme bumper height (G2 or 95 cm) (odds ratio, 1.57; 95% confidence interval, 1.14Y2.16) and upper aerodigestive tract malignancy as the operative indication (odds ratio, 1.54; 95% confidence interval, 1.06Y2.26) were significantly associated with complications. CONCLUSION: Although pull PEG tube placement is typically a straightforward procedure, morbidity can be significant. Bumper height is an easily modifiable variable; obtaining the proper height for each patient could decrease complications after PEG tube placement.
AB - BACKGROUND: As the role of acute care surgery (ACS) becomes more prevalent, clinicians in this specialty will be placing more percutaneous endoscopic gastrostomy (PEG) tubes. In this contemporary series of ACS PEG procedures, we hypothesized that technical aspects of PEG tube placement may play an important role. METHODS: For our retrospective study, we queried our tertiary Level I trauma center's prospectively maintained ACS database for PEG tube placement. Our study period was from July 1, 2010, through June 30, 2012.We excluded patients who underwent "push" PEG placement, an outpatient PEG tube placement, or an open or laparoscopic gastrostomy tube operation. We conducted a multivariate logistic regression analysis of factors contributing to complications. RESULTS: During our 24-month study period, of 184 patients, 133 underwent "pull" PEG tube placement with sufficient data for analysis. The mean (SD) agewas 56 (22) years; 66%were male. Overall, 33 (25%) experienced complications: 13 (10%) were major and 20 (15%) were minor complications. In our multivariate logistic regression analysis, we found that an extreme bumper height (G2 or 95 cm) (odds ratio, 1.57; 95% confidence interval, 1.14Y2.16) and upper aerodigestive tract malignancy as the operative indication (odds ratio, 1.54; 95% confidence interval, 1.06Y2.26) were significantly associated with complications. CONCLUSION: Although pull PEG tube placement is typically a straightforward procedure, morbidity can be significant. Bumper height is an easily modifiable variable; obtaining the proper height for each patient could decrease complications after PEG tube placement.
KW - Complications
KW - PEG
KW - Percutaneous endoscopic gastrostomy
UR - http://www.scopus.com/inward/record.url?scp=84890078023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890078023&partnerID=8YFLogxK
U2 - 10.1097/TA.0b013e3182a74b4d
DO - 10.1097/TA.0b013e3182a74b4d
M3 - Article
C2 - 24158207
AN - SCOPUS:84890078023
SN - 2163-0755
VL - 75
SP - 859
EP - 863
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 5
ER -