Background: Over 160,000 PEG placement procedures are performed each year in the US and 8.1% of all long-term care residents receive feeding via PEG tube. The objective of the study was to explore reasons for hospital re-admissions of long-term care residents with a PEG-tube.
Methods: A one-year retrospective study of long-term care PEG-fed residents over the age of 18 in two facilities. Data included: demographics, reasons for PEG placement, number of hospital re-admissions, reason for readmission and presence of associated PEG-tube complications or adverse events.
Results: The average age of the 36 residents who fit our inclusion criteria was 79.9 years (range 54-93), and 63.9% were female. The majority were white (69.4%), African American (16.7%) and Asian (2.8%). Most were married (47.2%) or widowed (22.2%). Reasons for PEG placement included: stroke (27.8%), cancer (11.1%), failure to thrive (11.1%), Parkinson’s disease (8.3%), dementia (5.6%), traumatic brain injury (2.8%) and other (33.3%). Only 9.4% had normal cognitive function while over a third (37.5%) had severe cognitive impairment and 31.3% had mild impairment. The overwhelming majority (93.1%) had albumin level <3.5 mg/dl. With regard to re-hospitalizations in the one-year study period, 88.4% had more than one, 44.1% more than two, 29.7% three, and 16.2% had four re-admissions. Reasons for re-hospitalizations associated with the presence of PEG included: tube dysfunction (dislodged, clogged and peritube leakage, 48.3 %), pneumonia (44.8 %), GI bleeding (13.9%), and abdominal wall abscess (2.8%). Other reasons included: sepsis (27.8%), respiratory distress (25.0%), anemia (2.8%), altered mental
status (11.1%), infected decubitus ulcer (8.3%), infected wound (5.6%) and other (22.2%). Overall one-year mortality was 11.1% (n=4).
Conclusions: These findings suggest that most long-term care residents with a PEG tube are re-hospitalized at least once within a one-year period after the PEG placement due to complications related to the PEG. Healthcare professionals, family members and caregivers need to be educated with regard to the risk/benefit ratio of PEG procedures.