Percutaneous Endoscopic Gastrostomy Tube Insertion in Neurodegenerative Disease: A Retrospective Study and Literature Review

Background/Aims: With the notable exceptions of dementia, stroke and motor neurone disease, relatively little is known regarding the safety and utility of percutaneous endoscopic gastrostomy (PEG) tube insertion in patients with neurodegenerative disease. We sought to determine the safety and utility of PEG feeding in the context of neurodegenerative disease and to complete a literature review with the aim of identifying whether particular factors need to be taken into consideration to improve safety and outcome.Method: A retrospective review of case notes of patients referred by neurologists for PEG in a single neurosciences centre were reviewed according to a pre-determined set of standards. For the literature review, we identified references from searches of PubMed, mainly with the search items ‘percutaneous endoscopic gastrostomy’ and ‘neurology’ or neurodegenerative disease’. Results: Short term mortality and morbidity associated with PEG in patients with neurological disease were significant. Age greater than 75 years was associated with poor outcome and there was trend towards adverse outcome in those with low serum albumin. Conclusion: This study highlights the relatively high risk of PEG in patients with neurodegenerative disease. We present points for consideration with the aim of improving outcome in this particularly vulnerable group of patients.