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Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis
- Source :
- Intestinal Research, Vol 14, Iss 4, Pp 333-342 (2016), Intestinal Research
- Publication Year :
- 2016
- Publisher :
- Korean Association for the Study of Intestinal Diseases, 2016.
-
Abstract
- Background/Aims: A percutaneous gastrostomy can be placed either endoscopically (percutaneous endoscopic gastrostomy, PEG) or radiologically (radiologically-inserted gastrostomy, RIG). However, there is no consistent evidence of the safety and efficacy of PEG compared to RIG. Recently, 30-day mortality has become considered as the most important surrogate index for evaluating the safety and efficacy of percutaneous gastrostomy. The aim of this meta-analysis was to compare the 30- day mortality rates between PEG and RIG. Methods: Major electronic databases (MEDLINE, Embase, Scopus, and Cochrane library) were queried for comparative studies on the two insertion techniques of gastrostomy among adults with swallowing disturbance. The primary outcome was the 30-day mortality rate after gastrostomy insertion. Forest and funnel plots were generated for outcomes using STATA version 14.0. Results: Fifteen studies (n=2,183) met the inclusion criteria. PEG was associated with a lower risk of 30-day mortality after tube placement compared with RIG (odds ratio, 0.60; 95% confidence interval [CI], 0.38-0.94; P =0.026). The pooled prevalence of 30-day mortality of PEG was 5.5% (95% CI, 4.0%-6.9%) and that of RIG was 10.5% (95% CI, 6.8%-14.3%). No publication bias was noted. Conclusions: The present meta-analysis demonstrated that PEG is associated with a lower probability of 30-day mortality compared to RIG, suggesting that PEG should be considered as the first choice for long-term enteral tube feeding. Further prospective randomized studies are needed to evaluate and compare the safety of these two different methods of gastrostomy. (Intest Res 2016;14:333-342)
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
lcsh:Medicine
Cochrane Library
Lower risk
03 medical and health sciences
0302 clinical medicine
Percutaneous endoscopic gastrostomy
medicine
Mortality
lcsh:RC799-869
Gastrostomy
business.industry
Mortality rate
lcsh:R
Gastroenterology
Endoscopy
Odds ratio
Confidence interval
Surgery
Meta-analysis
Fluoroscopy
Original Article
030211 gastroenterology & hepatology
lcsh:Diseases of the digestive system. Gastroenterology
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 22881956 and 15989100
- Volume :
- 14
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Intestinal Research
- Accession number :
- edsair.doi.dedup.....547910fac897e7c9d227c2b7b8303f64