Trends regarding percutaneous endoscopic gastrostomy: A nationwide population-based study from 1997 to 2010.
Trends regarding percutaneous endoscopic gastrostomy: A nationwide population-based study from 1997 to 2010.
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DOI：
10.1097/md.0000000000003910
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发表时间：
2016-06
期刊：
影响因子：
1.6
通讯作者：
Lin CS
中科院分区：
文献类型：
--
作者：
Chang WK;Lin KT;Tsai CL;Chung CH;Chien WC;Lin CS
经皮内镜胃造口术（PEG）广泛用于需要长期管饲的患者。传统的PEG研究通常集中在实践，技术和伦理问题。在亚洲，关于PEG利用和服务的流行病学研究很少。我们评估了1997年至2010年台湾PEG利用率、患者选择、患者特征和医疗服务的变化。本回顾性研究分析了1997年至2010年期间根据国际疾病分类第九版（程序代码43.11）从国民健康保险数据库中提取的接受PEG管放置的患者数据。从1997年到2010年，PEG的发生率从0.1/105人群增加到3.8/105人群，老年患者的PEG发生率从0.9/105人群增加到19.0/105人群。与1997-2004年和2005-2010年相比，脑血管病的比例在后期有所下降，食管癌的比例有所上升。PEG主要在男性患者和医疗中心进行。2005-2010年期间的医疗费用、Charlson Comorbid指数（CCI）评分和PEG后死亡率高于1997-2004年期间。PEG手术在台湾越来越多地进行，并注意到患者选择的变化。接受PEG治疗的患者的伴随疾病、医疗费用和PEG后死亡率的严重性增加。本研究结果可能有助于PEG的实施，医疗资源的重新配置，并改善PEG相关的护理。
Percutaneous endoscopic gastrostomy (PEG) is widely used in patients requiring long-term tube feeding. Traditional PEG studies usually focused on practical, technical, and ethical issues. There have been little epidemiological studies on PEG utilization and services in Asia. We evaluated the changes in PEG utilization, patient selection, patient characteristics, and medical service in Taiwan from 1997 to 2010. This retrospective study analyzed the data of patients admitted for PEG tube placement according to the International Classification of Diseases, Ninth Revision (procedure code 43.11) extracted from the National Health Insurance database between 1997 and 2010. From 1997 to 2010, the incidence of PEG increased from 0.1 to 3.8/105 population and incidence of PEG among aged patients increased from 0.9 to 19.0/105 population. Compared 1997–2004 to 2005–2010 periods, the percentage of cerebrovascular diseases decreased and esophageal cancer increased in the later period. PEG was mainly performed in male patients and at medical centers. Medical costs, Charlson Comorbidity Index (CCI) scores, and post-PEG mortality rates were higher in the 2005–2010 period than in the 1997–2004 period. PEG procedures are being increasingly performed in Taiwan, and changes in patient selection were noted. The seriousness of accompanying diseases, medical costs, and post-PEG mortality rates in patients undergoing PEG has increased. The present findings may help in the implementation of PEG, relocation of medical resources, and improvement of PEG-related care.