The frequency of emergency admissions for long term percutaneous endoscopic gastrostomy complications in England 2014-2021 and associated factors: a population-based study.

INTRODUCTION: Nutrition support teams can prevent emergency admissions of patients with percutaneous endoscopic gastrostomy (PEG) complications. We examined their impact on emergency admissions with PEG complications. METHODOLOGY: Adults undergoing their first PEG insertion in England from 2014 to 2021 were identified in Hospital Episode Statistics. Long term complications (>30 days after PEG) were identified using ICD-10 codes. Data on NHS provider nutrition support teams were available from the Get It Right First Time (GIRFT) national speciality report, March 2021. Cox proportional hazards models examined associations between PEG complications and emergency and elective admissions. RESULTS: Of 51,630 patients with a first PEG insertion, 59.4% were men, and the median age was 68 years (IQR 56-78). 11.5% had an emergency admission with a PEG complication: 12.6% at providers without a nutrition support team, compared with 11.3% at providers with a nutrition support team. Factors associated with emergency admissions for PEG complications in patients with a previous elective PEG insertion included: female sex adjusted hazard rate (aHR) 1.21(1.12-1.31); oesophageal cancer as indication (aHR 1.60(1.24-2.06); more recent PEG insertion (2021 aHR 1.22(1.00-1.49)); higher socioeconomic status aHR 0.72(0.64-0.82); and lack of data on provider nutrition support team (results consistent with providers with no nutrition support team) aHR 1.24(1.02-1.50). CONCLUSIONS: 11.5% of patients had an emergency admission with a complication within 5 years of PEG insertion. Nutrition support teams in secondary care appeared to be associated with fewer emergency admissions with PEG complications.