Higher serum albumin level after PEG tube insertion predicts longer survival
Survival after percutaneous endoscopic gastrostomy (PEG) tube insertion in elderly patients with severe dementia is potentially influenced by a higher serum albumin level at baseline and a stable/increased serum albumin level during follow-up, suggest a recent study.
Researchers enrolled 189 patients (aged ≥64 years) with severe dementia who underwent PEG tube insertion from 2002 to 2011 at a tertiary hospital and followed through 2014 to determine the factors affecting survival after such procedure. They collected data on background diseases, laboratory tests conducted 14 days before and 90 days after PEG, and date of death.
Multivariate Cox regression analysis was performed and cumulative survival curves plotted.
Patients who died ≤30 days after PEG (n=32; 16.9 percent) had significantly lower mean baseline serum albumin level than those who survived longer (2.9 vs 3.3 g/dL; p<0.001). Also, patients who survived 1 year after PEG (n=96; 50.8 percent) had significantly higher serum albumin level than those who died earlier (3.4 vs 3.1 g/dL; p=0.002). There were no significant differences in other laboratory parameters.
A serum albumin level above the median (3.3 g/dL) was the sole predictor of survival after adjustment for background diseases (hazard ratio [HR], 0.51; 95 percent CI, 0.37 to 0.72; p<0.001). A stable/increased serum albumin levels at 90 days after PEG resulted in longer survival in patients, compared with decreased levels.
After adjustment for age and background diseases, the only predictor of survival was a stable/increased albumin level at 90 days (HR, 0.59; 0.42 to 0.85; p=0.004).
These findings support a previous study which concluded the potential of serum albumin to predict early survival in individuals undergoing PEG tube placement. [JPEN J Parenter Enteral Nutr 1997;21:72-4]