Proton Pump Inhibitor Use before Percutaneous Endoscopic Gastrostomy Is Associated with Adverse Outcomes
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Background/Aims: Knowledge of the risk factors associatedwith adverse outcomes after percutaneous endoscopicgastrostomy (PEG) may be helpful for developing PEG recommendations. The purpose of this study was to identify theclinical risk factors associated with adverse clinical outcomesafter PEG, especially regarding the use of proton pump inhibitors(PPIs). Methods: We retrospectively reviewed the datafrom PEG patients at seven university hospitals betweenJune 2006 and January 2012. All patients were followed upthrough February 2012 after PEG, and the clinical risk factorsfor adverse clinical outcomes after PEG were analyzed. Results: Data from 1,021 PEG patients were analyzed. PPIusers were more frequently included in the complicationgroup than the noncomplication group (p=0.040). PEG-relatedcomplications (p=0.040) and mortality (p=0.003) weremore frequent in the PPI group than in the control group. Inthe subgroup analysis of complicated PEG cases, infectiouscomplications were more frequently found in the PPI groupthan in the control group (35.8% vs 27.8%). After adjustmentfor multiple possible confounding factors, PPI users (oddsratio, 1.531; 95% confidence interval, 1.017 to 2.305) anddiabetic patients had increased mortality after PEG. Conclusions:PPI use may be associated with adverse outcomes inpatients with PEG; however, further prospective studies investigatingthis issue are warranted.
Abstract
Background/Aims: Knowledge of the risk factors associatedwith adverse outcomes after percutaneous endoscopicgastrostomy (PEG) may be helpful for developing PEG recommendations. The purpose of this study was to identify theclinical risk factors associated with adverse clinical outcomesafter PEG, especially regarding the use of proton pump inhibitors(PPIs). Methods: We retrospectively reviewed the datafrom PEG patients at seven university hospitals betweenJune 2006 and January 2012. All patients were followed upthrough February 2012 after PEG, and the clinical risk factorsfor adverse clinical outcomes after PEG were analyzed. Results: Data from 1,021 PEG patients were analyzed. PPIusers were more frequently included in the complicationgroup than the noncomplication group (p=0.040). PEG-relatedcomplications (p=0.040) and mortality (p=0.003) weremore frequent in the PPI group than in the control group. Inthe subgroup analysis of complicated PEG cases, infectiouscomplications were more frequently found in the PPI groupthan in the control group (35.8% vs 27.8%). After adjustmentfor multiple possible confounding factors, PPI users (oddsratio, 1.531; 95% confidence interval, 1.017 to 2.305) anddiabetic patients had increased mortality after PEG. Conclusions:PPI use may be associated with adverse outcomes inpatients with PEG; however, further prospective studies investigatingthis issue are warranted.
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