Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) is a widely accepted method for long-term enteral nutrition, but procedure-related complications and early mortality remain major concerns. Nutritional and inflammatory indices such as serum albumin, C-reactive protein (CRP), Prognostic Nutritional Index (PNI), and Nutrition Risk Screening (NRS-2002) may provide prognostic value, yet comparative data in PEG cohorts are limited. This study aimed to identify predictors of complications and 90-day mortality after PEG and to compare the prognostic performance of nutritional indices. Materials and Methods: A retrospective cohort of 122 consecutive adult patients undergoing PEG between January and December 2024 was analyzed. Demographic, clinical, and laboratory parameters were collected, including albumin, CRP, PNI, and NRS-2002. Complications were categorized as early (≤30 days) or late (>30 days), and all-cause mortality was assessed at 30 and 90 days. Univariate and multivariate logistic regression models were used to evaluate predictors of complications and 90-day mortality. To address multicollinearity, albumin, PNI, and NRS-2002 were separately tested in adjusted models, with model performance assessed by AIC, BIC, Nagelkerke R², and C-index. Results: Early complications occurred in 4.9% and late complications in 8.2% of patients, for a total complication rate of 13.1%. Thirty-day mortality was 4.1%, 90-day mortality 17.2%, and total in-hospital mortality during the study year 30.3%. Neuromuscular indication was independently associated with increased risk of complications (aOR 5.0, 95% CI 1.2–20.0, p = 0.028) but reduced 90-day mortality (aOR 0.15, 95% CI 0.03–0.80, p = 0.025). Lower baseline albumin independently predicted higher 90-day mortality (aOR 0.92, 95% CI 0.86–0.99, p = 0.034). Elevated CRP demonstrated a borderline association with mortality (p = 0.051), while NRS-2002 ≥5 and Δ-PNI showed borderline trends toward increased mortality risk. In model comparison, none of the nutritional indices achieved independent statistical significance, but all demonstrated similar performance (AIC = 114, C-index 0.72–0.74). Conclusions: PEG outcomes are strongly influenced by baseline indication and nutritional–inflammatory status. Neuromuscular patients and patients with dysphagia face higher complication risk but lower short-term mortality, while hypoalbuminemia, elevated CRP, and high NRS-2002 or declining PNI identify patients at greater risk of death. Systematic integration of albumin, CRP, PNI, and NRS-2002 may improve risk stratification and management in PEG candidates.

Background/Objectives: This study aimed to evaluate the clinical outcomes, complications, and one-year mortality of patients undergoing percutaneous endoscopic gastrostomy (PEG) in different care settings (hospital, nursing home, and home). Additionally, we investigated the comparative prognostic role of the prognostic nutritional index (PNI) and the CRP-to-albumin ratio (CAR) in predicting mortality among these patients. Methods: A retrospective analysis of 236 adult patients who underwent PEG placement between January 2022 and December 2023 was performed. Demographic, clinical, and laboratory data were collected. The PNI was calculated according to the following formula: PNI = 10 × (albumin) + 0.005 × (lymphocyte count). The CAR was obtained by the ratio of the CRP level to the albumin level. Patients were categorized based on their post-PEG care settings. Results: Neurologic disorders were the most common indication for PEG (69.9%). The one-year mortality was 32.2%, with a median survival of 38 weeks (95% CI: 35–41). In the multivariable model, a lower PNI (HR = 0.93, 95% CI: 0.89–0.97, p < 0.001), as well as being followed in a hospital setting, emerged as independent predictors of mortality. Patients with timely PEG tube replacement showed a reduced mortality risk. The ROC analysis showed that the PNI had a higher AUROC (0.78 ± 0.04) compared to the CAR (0.69 ± 0.04), indicating superior prognostic accuracy for predicting one-year mortality. Conclusions: Care settings significantly influence survival outcomes, with better mortality rates observed in nursing homes and home environments. The PNI was superior to the CAR in predicting one-year mortality, emphasizing its clinical utility in risk stratification for PEG patients. Proactive tube management and individualized care strategies are critical for improving the prognosis in this population.

Background: Malnutrition is increasingly prevalent due to rising life expectancy, oncological cases, and chronic diseases. Early detection is crucial for rehabilitation, complication prevention, and cost reduction. However, nutritional support is often suboptimal. This study aimed to determine malnutrition prevalence and nutritional support status within our hospital. Methods: A point prevalence study was conducted in adult inpatient clinics (excluding pediatrics, infectious diseases, and intensive care) by a 12-member team following ethical approval. NRS-2002 scores, arm/calf circumferences, BMI, and laboratory data (albumin, leukocytes, lymphocytes, neutrophils, hemoglobin, CRP, creatinine) were assessed. Enteral and parenteral nutrition treatments were recorded. Patients with NRS-2002 scores ≥ 3 were classified as at risk of malnutrition. Results: Among 178 patients, 24.7% were at risk of malnutrition. Surgical clinics had a higher malnutrition risk (32.3%) than internal medicine clinics (20.3%). Only 27.1% of at-risk patients received nutritional support (surgical: 19%, internal medicine: 44%). Patients at risk of malnutrition exhibited significantly lower arm circumference (p: 0.000), calf circumference (p: 0.002), lymphocyte counts (p: 0.000), hemoglobin (p: 0.018), albumin (p: 0.001), and BMI (p: 0.038), as well as significantly higher age (p: 0.000) and CRP levels (p: 0.000). Conclusions: Nutritional support remains inadequate despite increased attention to malnutrition. Intensified nutrition education, particularly in surgical inpatient clinics, is needed to improve patient rehabilitation and outcomes.

Percutaneous Endoscopic Gastrostomy: Peristomal Leakage - Journal of Academic Research in Nursing