%0 Journal Article
%T A Comprehensive Examination of Percutaneous Endoscopic Gastrostomy and Its Association with Amyotrophic Lateral Sclerosis Patient Outcomes
%J Brain Sciences | An Open Access Journal from MDPI
%D 2019
%R https://doi.org/10.3390/brainsci9090223
%X There is literature discord regarding the impact of percutaneous endoscopic gastrostomy (PEG), or ¡°feeding tube¡±, on amyotrophic lateral sclerosis (ALS) outcomes. We assess one of the largest retrospective ALS cohorts to date (278 PEG users, 679 non-users). Kruskal¨CWallis and Kaplan¨CMeier analysis compared cohort medians and survival duration trends. A meta-analysis determined the aggregate associative effect of PEG on survival duration by combining primary results with 7 published studies. Primary results ( p < 0.001) and meta-analysis ( p < 0.05) showed PEG usage is associated with an overall significant increase in ALS survival duration, regardless of onset type. Percent predicted forced vital capacity (FVC %predict) ¡Ý50 at PEG insertion significantly increases survival duration ( p < 0.001); FVC %predict ¡Ý60 has the largest associative benefit (+6.7 months, p < 0.05). Time elapsed from ALS onset until PEG placement is not predictive ( p > 0.05). ALSFRS-R survey assessment illustrates PEG usage does not slow functional ALS pathology ( p > 0.05), but does stabilize weight and/or body mass index (BMI) ( p < 0.05). Observed clinical impression of mood (CIM), was not impacted by PEG usage ( p > 0.05). Overall results support PEG as a palliative intervention for ALS patients with ¡Ý50 FVC %predict at PEG insertion. View Full-Tex
%U https://www.mdpi.com/2076-3425/9/9/223