Albumin and C-reactive protein levels predict short-term mortality after percutaneous endoscopic gastrostomy in a prospective cohort study

作者：Blomberg John^*; Lagergren Pernilla; Martin Lena; Mattsson Fredrik; Lagergren Jesper

来源：Gastrointestinal Endoscopy, 2011, 73(1): 29-36.

DOI：10.1016/j.gie.2010.09.012

Background: Percutaneous endoscopic gastrostomy (PEG) is a procedure with many complications that sometimes can be devastating. To give better advice to patients referred for PEG regarding risk of complications, important risk factors should be known.
Objective: To evaluate whether age, body mass index, albumin levels. C-reactive protein (CRP) levels, indication for PEG, and comorbidity influence the risk of mortality or peristomal infection after PEG insertion.
Design: Prospective cohort study from 2005 to 2009. Follow-up 14 days after PEG.
Setting: University hospital.
Patients: This study involved 484 patients referred for PEG.
Intervention: PEG.
Main Outcome Measurements: Mortality within 30 clays and peristomal infection within 14 clays after PEG insertion. All risk estimates were calculated with 95% CIs and adjusted for confounding.
Results: Among 484 patients, 58 (12%) died within 30 clays after PEG insertion. Albumin <30 g/L (hazard ratio 3.46; 95% Cl 1.75-6.88), CRP >= 10 (HR, 3.47; 95% CI, 1.68-7.18), age >= 65 years (HR, 2.26; 95% CI 1.20-4.25) and possibly body mass index <18.5 (HR, 2.04; 95% CI, 0.97-4.31) were associated with increased mortality. Patients with a combination of low albumin and high CRP levels had a mortality rate of 20.5% compared with 2.6% among patients with normal values, rendering an over 7-fold increased adjusted risk of mortality (HE, 7.45; 95% Cl, 2.62-21.19).
Limitations: Missing data in some study variables. Although the sample size was large, weaker associations could not be established.
Conclusion: The combination of low albumin and high CRP levels indicates a substantially increased short-term mortality risk after PEG, which should be considered in decision making. (Gastrointest Endose 2011;73:29-36.)

• 出版日期2011-1