PD438 - WEIGHT TRAJECTORIES AND SURVIVAL FOLLOWING PEG INSERTION IN PATIENTS WITH MOTOR NEURONE DISEASE AT A SINGLE SITE UNIVERSITY HOSPITAL: A RETROSPECTIVE COHORT STUDY

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PD438

WEIGHT TRAJECTORIES AND SURVIVAL FOLLOWING PEG INSERTION IN PATIENTS WITH MOTOR NEURONE DISEASE AT A SINGLE SITE UNIVERSITY HOSPITAL: A RETROSPECTIVE COHORT STUDY

M. Joyce1,*, J. Li1, S. Pittendrigh1, D. Rowe1, S. Kuo2, W. J. R. Fokkink1, J. Trinh3, A. Dollman4, M. Parr5, E. Liu4

1Neurology, MQ Health, 2Gastroenterology, Macquarie GI, 3Anesthesiology, 4Respiratory, 5ICU, MQ Health, Sydney, Australia

 

Rationale: Percutaneous endoscopic gastrostomy (PEG) supports nutrition in MND, but its capacity to stabilise or increase weight remains uncertain. Insertion before >10% weight loss may improve survival (1). The impact of pre- and post-PEG weight trajectories on survival, nutritional recovery, and optimal timing remains unclear.

 

Methods: This single-site retrospective cohort (2011–2025) included 103 MND patients undergoing PEG. Procedures were performed by a consistent multidisciplinary team with planned ICU admission. Timing reflected clinical need and patient preference, supported by in-house funding. Outcomes were post-PEG weight change and associations with pre-PEG weight loss (%), onset type, BMI and survival. Weight was recorded at diagnosis, pre-PEG and 1 month then 3-monthly. Change was defined as gain (≥1 kg), loss (≥1 kg) or stable (±1 kg).

Results: Of 103 patients (63F, 40M), 62 had bulbar-onset MND. Ten died within one month. Post-PEG weight data were available for 70; survival for 98. Post-PEG, 44.3% lost weight (mean 5.1 kg) with shortest survival (8.6 months); 32.9% gained (mean 4.8 kg); 22.8% remained stable. Pre-PEG weight loss severity did not predict trajectory, although <10% loss was associated with longer survival (12 vs 8 months). Weight gain occurred regardless of prior loss. PEG within 12 months of diagnosis improved weight gain/stability and survival. Bulbar-onset patients were more likely to lose weight post-PEG; gain was more common in limb-onset disease. Survival was 8.8 months post-PEG and 29.3 months from diagnosis.

Conclusion: A multidisciplinary PEG care model, with insertion before nutritional decline (<10% weight loss from baseline), was associated with improved survival. Patients with <10% pre-PEG loss were less likely to lose weight, supporting timely intervention.

References: (1)de Carvalho Vilar et al. Nutrients. 2025;17:782

Disclosure of Interest: None declared