TY - JOUR
T1 - Reducing accidental dislodgement of the percutaneous endoscopic gastrostomy
AU - Rosenberger, Laura H.
AU - Guidry, Christopher A.
AU - Davis, John P.
AU - Hranjec, Tjasa
AU - Johnston, Vonda K.
AU - Wages, Nolan A.
AU - Watson, Christopher M.
AU - Sawyer, Robert G.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this study included an internal grant from the University of Virginia’s Graduate Medical Education office. This Key Grant Quality and Patient Safety Award comprised $3,845 during 2011-2012 and covered device prototyping, ex vivo model building, and testing expenses. This study was subsequently supported by a $50 000 award from the University of Virginia’s Ivy Foundation under the Biomedical Innovation Fund. This funding was awarded from 2011-2012 and covered materials, device prototyping, engineering support, and clinical trial resources. Neither University of Virginia grants had requirements regarding specifications for a clinical study or manuscript preparation.
Publisher Copyright:
© The Author(s) 2015.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background. The percutaneous endoscopic gastrostomy (PEG) is a ubiquitous feeding tube with high rates of accidental dislodgement, with significant morbidity and health care costs. We hypothesized use of a decoupling device is a safe and effective mechanism to reduce dislodgements. Study Design. We studied a prospective cohort of 100 patients from an academic center. Enrollment included patients requiring PEG tube placement with follow up extending through an individual's lifetime use of their PEG tube. The primary endpoint was accidental dislodgement of the principally placed PEG tube. The secondary endpoint was time to accidental dislodgement of the PEG tube. Results. All 100 patients received the SafetyBreak device and had complete follow-up. Half of the patients had at least a single episode of device decoupling, indicating prevention of dislodgement of the PEG. Eight patients ultimately had dislodgement, resulting in a significantly lower dislodgement rate when compared with a historical cohort (P =.036) and significantly longer survival of the PEG (log rank = 0.005). When compared with a concurrent cohort (without the device) there was also significantly lower dislodgement rate (P =.03) and a trend toward longer survival of the PEG (log rank = 0.08). Conclusions. When compared with both a historical and concurrent cohort of patients, the SafetyBreak device reduces accidental dislodgement of PEG tubes. As an increasing number of PEGs are being placed, an increasing number of patients are at risk for dislodgement. The SafetyBreak device is an innovative, economical solution to the problem of accidental dislodgement of the PEG tube.
AB - Background. The percutaneous endoscopic gastrostomy (PEG) is a ubiquitous feeding tube with high rates of accidental dislodgement, with significant morbidity and health care costs. We hypothesized use of a decoupling device is a safe and effective mechanism to reduce dislodgements. Study Design. We studied a prospective cohort of 100 patients from an academic center. Enrollment included patients requiring PEG tube placement with follow up extending through an individual's lifetime use of their PEG tube. The primary endpoint was accidental dislodgement of the principally placed PEG tube. The secondary endpoint was time to accidental dislodgement of the PEG tube. Results. All 100 patients received the SafetyBreak device and had complete follow-up. Half of the patients had at least a single episode of device decoupling, indicating prevention of dislodgement of the PEG. Eight patients ultimately had dislodgement, resulting in a significantly lower dislodgement rate when compared with a historical cohort (P =.036) and significantly longer survival of the PEG (log rank = 0.005). When compared with a concurrent cohort (without the device) there was also significantly lower dislodgement rate (P =.03) and a trend toward longer survival of the PEG (log rank = 0.08). Conclusions. When compared with both a historical and concurrent cohort of patients, the SafetyBreak device reduces accidental dislodgement of PEG tubes. As an increasing number of PEGs are being placed, an increasing number of patients are at risk for dislodgement. The SafetyBreak device is an innovative, economical solution to the problem of accidental dislodgement of the PEG tube.
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U2 - 10.1177/1553350615587408
DO - 10.1177/1553350615587408
M3 - Article
C2 - 26002112
AN - SCOPUS:84952913543
SN - 1553-3506
VL - 23
SP - 62
EP - 69
JO - Seminars in Laparoscopic Surgery
JF - Seminars in Laparoscopic Surgery
IS - 1
ER -