July 12, 2020
Nearly a third of patients with Parkinson disease and related conditions who lived at home before percutaneous endoscopic gastrostomy (PEG) were discharged to nursing or care homes after the procedure, according to a study published in the journal Movement Disorders Clinical Practice.
“PEG can facilitate feeding and medication administration in dysphagic patients with Parkinson disease and related disorders,” researchers wrote. “Information on survival, institutionalization, and complications post PEG might inform feeding decisions.”
Researchers conducted a retrospective review of case notes for 83 patients with Parkinson’s disease or related disorders identified using PEG registers and databases from two large university hospitals in the United Kingdom. Among the study population, 70% had Parkinson's disease, 12% had progressive supranuclear palsy, 8% had vascular parkinsonism, 6% had multiple system atrophy, and 4% had dementia with Lewy bodies. The median age of participants was 78.
In 82% of patients, PEG was placed during emergency admission. The median survival after PEG was 422 days, according to the study, and the 30-day mortality rate was 6%. Among 56 patients admitted to the hospital from home, 32% were discharged to nursing or care institutions after PEG.
The most common complication was aspiration pneumonia, the study found, which affected 22% of patients. Discharge to home and follow-up by the home enteral feeding team were both associated with longer survival.
“Further research is needed on quality-of-life post PEG and ways to reduce aspiration pneumonia,” researchers advised. “All PEG patients should have nutrition team follow-up.”
Brown L, Oswal M, Samra AD, et al. Mortality and Institutionalization After Percutaneous Endoscopic Gastrostomy in Parkinson's Disease and Related Conditions. Mov Disord Clin Pract. 2020;7(5):509-515. Published 2020 Jun 9. doi:10.1002/mdc3.12971