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PTU-005 Neurodegeneration as a prognostic factor post gastrostomy insertion: to PEG or not to PEG?
  1. K E Evans1,
  2. J S Leeds1,
  3. H E Robson1,
  4. M E McAlindon1,
  5. J Grant1,
  6. M Hadjivassiliou2,
  7. D S Sanders1
  1. 1Department of Gastroenterology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
  2. 2Department of Neurology, Sheffield teaching Hospitals NHS Trust, Sheffield, UK

Abstract

Introduction Gastrostomy insertion is well-accepted as a method for medium and long-term feeding. Although gastrostomy insertion in dementia is recognised as having a poor outcome there is a paucity of data pertaining to other neurodegenerative disease (examples: motor neurone disease, Parkinson's disease and multiple sclerosis).

Methods The aim of the study was to compare the mortality of patients with neurodegenerative disease undergoing gastrostomy with other subgroups requiring the procedure. Data for all patients referred for PEG insertion at our institute are prospectively included in a database. PEG referrals from February 2004 to February 2007 were analysed. Patient demographics, indications and outcome were extracted. Group 1 acute brain injury (acute stroke, head injury, subarachnoid haemorrhage), Group 2 oropharyngeal malignancy, Group 3 neurodegenerative diseases and Group 4 other/miscellaneous (cystic fibrosis, cerebral palsy, severe pneumonia, mucopolysaccharidoses, oesophageal stricture).

Results 403 gastrostomies were performed (268 males, median age 64, range 18–94). Patients with neurodegenerative diseases have a worse outcome by comparison to other disease subgroups at 1 year (with a mortality of 74%, p<0.002). This did not alter after adjusting for age at time of gastrostomy.

Conclusion This is the first study to observe that patients with neurodegenerative disease have a higher mortality at 1 year after gastrostomy insertion than other subgroups referred. This may reflect the underlying disease. This observation has implications when discussing timing of gastrostomy and obtaining informed consent.

Abstract PTU-005

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