Published online Mar 14, 2024. doi: 10.3748/wjg.v30.i10.1358
Peer-review started: November 15, 2023
First decision: December 14, 2023
Revised: December 27, 2023
Accepted: January 31, 2024
Article in press: January 31, 2024
Published online: March 14, 2024
Processing time: 120 Days and 1.7 Hours
Percutaneous endoscopic gastrostomy (PEG) and laparoscopically inserted gastrostomy have become the gold standard for adult patients and children, respectively, requiring long-term enteral nutrition support. Procedure-related mortality is a rare event, often reported to be zero in smaller studies. National data on 30-d mortality and long-term survival rates after gastrostomy placement are scarce in the literature.
To study the use of gastrostomies in Sweden from 1998-2019 and to analyze procedure-related mortality and short-term (< 30 d) and long-term survival.
In this retrospective, population-based cohort study, individuals that had received a gastrostomy between 1998-2019 in Sweden were included. Individuals were identified in the Swedish National Patient Register, and survival analysis was possible by cross-referencing the Swedish Death Register. The cohort was divided into three age groups: Children (0-18 years); adults (19-64 years); and elderly (≥ 65 years). Kaplan-Meier with log-rank test and Cox regression were used for survival analysis.
In total 48682 individuals (52% males, average age 60.9 ± 25.3 years) were iden
The annual use of gastrostomies in Sweden increased during the study period, with a shift towards more minimally invasive procedures. Although procedure-related death was rare, the overall 30-d mortality rate was high (10%). To overcome this, we believe that patient selection should be improved.
Core Tip: In this large population-based cohort of 48682 individuals, the use of gastrostomies in Sweden increased during the 22-year study period, from 13.7/100000 to 22.3/100000 individuals. Percutaneous endoscopic gastrostomy more than doubled, while a 10-fold increase was seen in laparoscopic gastrostomies. Although the procedure-related mortality was low (0.1%), a 10% 30-d mortality was seen. The latter, however, decreased from 11.6% in 1998-2009 to 8.5% in 2010-2019. One-year and ten-year survival rates for children, adults, and elderly were 93.7%, 67.5%, and 42.1% and 79.9%, 39.2%, and 6.8%, respectively. The most common causes of death were malignancies and cardiovascular and respiratory diseases.