Factors Associated with Mortality after Percutaneous Endoscopic Gastrostomy.



Percutaneous endoscopic gastrostomy (PEG) is a common procedure performed world-wide on patients with different comorbidities, with many indications and overall low morbidity. However, studies showed an elevated early mortality in patients undergoing PEG placement. In this systematic review, we review the factors associated with early mortality after PEG.


The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The methodological index for nonrandomized studies (MINORS) score system was used to perform qualitative assessment of all included studies. Recommendations were summarized for predefined key items.


The search found 283 articles. A refined total of 21 studies were included; 20 studies cohort studies and 1 case-control study. For the cohort studies, MINORS score ranged from 7 to 12 out of 16. The single case-control study scored 17 out of 24. The number of study patients ranged from 272 to 181,196. Thirty-day mortality rate varied from 2.4% to 23.5%. Albumin, age, body mass index, C-reactive protein, diabetes mellitus, and dementia were the most frequently associated factors to early mortality in patients undergoing PEG placement. Five studies reported procedure related deaths. Infection was the most commonly reported complication of PEG placement.


PEG tube insertion is a fast, safe and effective procedure, but is not free of complications and can have a high early mortality rate as demonstrated in this review. Patient selection should be a key factor and the identification of factors associated with early mortality is important in the elaboration of a protocol to benefit patients.





Published Version (Please cite this version)


Publication Info

Lima, Diego Laurentino, Luiz Eduardo Correia Miranda, Raquel Nogueira Cordeiro Laurentino Lima, Gustavo Romero-Velez, Ryan Chin, Phillip P Shadduck and Prashanth Sreeramoju (2023). Factors Associated with Mortality after Percutaneous Endoscopic Gastrostomy. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 27(2). p. e2023.00005. 10.4293/jsls.2023.00005 Retrieved from https://hdl.handle.net/10161/28287.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.


Phillip P. Shadduck

Assistant Consulting Professor in the Department of Surgery

Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.