P932 - INCREASED MORTALITY AND POOR NUTRITIONAL OUTCOMES WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) PLACEMENT IN DEMENTIA PATIENTS: INSIGHTS FROM A LARGE PROPENSITY-MATCHED ANALYSIS

P932

INCREASED MORTALITY AND POOR NUTRITIONAL OUTCOMES WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) PLACEMENT IN DEMENTIA PATIENTS: INSIGHTS FROM A LARGE PROPENSITY-MATCHED ANALYSIS

 

 

D. Hakimian^1,*, P. Roa², O. Perzon¹, Z. Daitch¹, Y. Ishay‏¹

¹Institute of Gastroenterology and Hepatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel, ²Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia

 

Rationale: Dementia, a degenerative neurocognitive disorder, often leads to dysphagia and malnutrition. Despite guidelines advising against PEG placement in patients with advanced dementia, the practice persists. This study evaluates outcomes following PEG placement in the largest propensity score-matched cohort to date.

Methods: Data were extracted from the TriNetX Research Network, encompassing de-identified patient records from 2010–2024, using the International Classification of Diseases (ICD) 10. Propensity score matching (1:1) controlled for demographics, socioeconomics, and comorbidities. Outcomes, including survival, healthcare utilization, and nutritional status, were analyzed using Kaplan-Meier and Student’s T-Test.

Results: A total of 31,620 patients were equally divided into PEG and No-PEG groups. PEG placement was associated with increased 30-day and one-year mortality (p < 0.05). Moreover, we found increased rates of aspiration pneumonia, pressure ulcers, malnutrition, surgeries, and severe sepsis in the PEG group (Table 1). Serum albumin levels, paradoxically lower in the PEG group after one year (p < 0.005), suggested worse nutritional status

 

Table 1

 

 

Outcome				No PEG Group (N = 15,810)	PEG Group (N = 15,810)	P value
Aspiration pneumonia				1,929 (12.2%)	2,912 (18.4%)	< 0.05
Malnutrition				4,657 (29.5%)	5,611 (35.5%)	< 0.05
Pressure ulcer				1,521 (11.4%)	1,971 (16.4%)	< 0.05
Severe sepsis				3,587 (22.7%)	4,541 (28.7%)	< 0.05

 

 

 

Conclusion: PEG placement in our cohort of advanced dementia patients correlates with higher mortality and adverse clinical outcomes, aligning with guidelines advising against its use. These findings underscore the importance of shared decision-making when considering PEG placement in this population

Disclosure of Interest: None declared