P148 - LONG TERM ENDOSCOPIC GASTROSTOMY ENTERAL FEEDING OF NEUROSURGICAL PATIENTS: A REFERENCE CENTER’S EXPERIENCE.

P148

LONG TERM ENDOSCOPIC GASTROSTOMY ENTERAL FEEDING OF NEUROSURGICAL PATIENTS: A REFERENCE CENTER’S EXPERIENCE.

C. Palma^1,*, I. Mendes¹, F. Vara-Luiz¹, I. Mocanu¹, G. Nunes¹, C. Oliveira¹, C. Santos², M. Brito², T. Meira¹, J. Fonseca¹

¹Gastroenterology, ²Hospital Garcia de Orta, Almada, Portugal

Rationale: Neurosurgical patients often face several difficulties with nutritional support due to severe brain injury, neurological disease, or post-surgical complications. This study aimed to assess the outcomes of long-term enteral nutrition via percutaneous endoscopic gastrostomy (PEG) in this population.

Methods: Single center, retrospective analysis of patients who were referred for PEG from 2001 to 2023. Patients who presented with severe traumatic brain injury (TBI), hemorrhagic stroke, brain tumor or other conditions that required neurosurgery were selected. Demographic, anthropometric and clinical data were recorded.

Results: 196 patients were included, 57% were younger than 65 years. Stroke (41.8%), TBI (35.2%) and brain tumors (19.9%) were the most frequent conditions. The median time from diagnosis to PEG was 94 days. At the time of PEG procedure, only 38.5% were underweight. 21 patients were lost to follow up. Among the remaining, 75.4% died, 12.6% were alive and PEG-fed, and 12% had the tube removed. Median overall survival post-PEG was 11.5 months, with 88% surviving more than one month. Albumin, transferrin, and total cholesterol levels at the time of PEG were associated with longer survival. Albumin (p<0.001) and transferrin (p<0.01) were significantly associated with lower short-term mortality risk.

Conclusion: PEG is an effective method for long-term enteral nutrition in neurosurgical patients. Although survival is limited, reflecting the severity of the underlying conditions, the majority of patients survived beyond one month, supporting the adequacy of the procedure. Higher serum albumin and transferrin levels were associated with longer survival.

Disclosure of Interest: None declared