Peritonitis from PEG tube insertion and ensuing complications in Surgical ICU patients: Identification of risk factors and clinical outcome

OBJECTIVE – Percutaneous Endoscopic Gastrostomy (PEG) tubes are routinely placed in Surgical Intensive Care Unit (SICU). Poor tissue healing or technical issues after tube insertion can lead to peritonitis requiring a laparotomy. Risk factors leading to this major complication are not identified.
METHODS – We conducted a retrospective review of all PEG tubes inserted in SICU patients from 2003 to 2006. The procedure was performed by 2 surgical intensivists. Patients’ age, sex, BMI, organ dysfunction scores, vasopressor use, fluid status, steroid use for medical reasons and nutritional status were noted. Peritonitis requiring laparotomy and mortality were among the outcomes. Multivariate logistic regression was used for data analysis (SAS v9.1).
RESULTS – Out of 322 patients, 16 (5%) patients needed a laparotomy for peritonitis and 74 (23%) patients expired during the hospital stay. Higher BMI and serum albumin lower than 2.5 were major predictors of the need for a laparotomy (p-value 0.0005 and 0.0008 respectively). Patients with BMI >30 and albumin

Session: Podium Presentation

Program Number: S106