Contemporary acute care surgery percutaneous endoscopic gastrostomy tube placement: An extreme bumper height and complications

Evan S. Glazer, Narong Kulvatunyou, Donald J. Green, Lynn Gries, Bellal Joseph, Terence OKeeffe, Andrew L. Tang, Julie L. Wynne, Randall S. Friese, Peter M. Rhee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)859-863
Number of pages5
JournalJournal of Trauma and Acute Care Surgery
Volume75
Issue number5
DOIs
StatePublished - Nov 1 2013
Externally publishedYes

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Gastrostomy
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
Trauma Centers
Outpatients
Retrospective Studies
Databases
Morbidity

Keywords

  • Complications
  • PEG
  • Percutaneous endoscopic gastrostomy

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Contemporary acute care surgery percutaneous endoscopic gastrostomy tube placement : An extreme bumper height and complications. / Glazer, Evan S.; Kulvatunyou, Narong; Green, Donald J.; Gries, Lynn; Joseph, Bellal; OKeeffe, Terence; Tang, Andrew L.; Wynne, Julie L.; Friese, Randall S.; Rhee, Peter M.

In: Journal of Trauma and Acute Care Surgery, Vol. 75, No. 5, 01.11.2013, p. 859-863.

Research output: Contribution to journalArticle

Glazer, Evan S. ; Kulvatunyou, Narong ; Green, Donald J. ; Gries, Lynn ; Joseph, Bellal ; OKeeffe, Terence ; Tang, Andrew L. ; Wynne, Julie L. ; Friese, Randall S. ; Rhee, Peter M. / Contemporary acute care surgery percutaneous endoscopic gastrostomy tube placement : An extreme bumper height and complications. In: Journal of Trauma and Acute Care Surgery. 2013 ; Vol. 75, No. 5. pp. 859-863.
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AU - Green, Donald J.

AU - Gries, Lynn

AU - Joseph, Bellal

AU - OKeeffe, Terence

AU - Tang, Andrew L.

AU - Wynne, Julie L.

AU - Friese, Randall S.

AU - Rhee, Peter M.

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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.

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