Percutaneous endoscopic gastrostomy tube placement is safe in patients undergoing corticosteroid therapy

Background: Percutaneous endoscopic gastrostomy tube placement is performed commonly in patients unable to eat. Corticosteroids have been shown to increase the incidence of infections in patients undergoing surgical gastrostomy. The safety of percutaneous endoscopic gastrostomy in patients receiving corticosteroids has not been demonstrated. Methods: A retrospective review of 746 patients undergoing percutaneous endoscopic gastrostomy at a single institution between January 2002 and June 2007 was performed. Patients receiving corticosteroid therapy either acutely or chronically were identified. Charts were reviewed for demographic information, diagnoses, comorbidities, complications, and death. Results: Seven hundred forty-six patients underwent percutaneous endoscopic gastrostomy tube placement of which only 745 charts were complete and available for review. Ninety-four patients (12.6%) were receiving steroids at the time of the procedure. Fifty-nine patients (7.9%) received steroids for two or less weeks (acute), and 35 patients (4.5%) received steroids for more than 2 weeks (chronic). The overall incidence of complications was 98/745 (13.3%). No significant difference in post-procedural complications occurred in patients not receiving steroids 83/651 (12.7%) and steroid recipients 15/94 (16.0%). There was no difference in complications between the acute steroid group 10/59 (16.9%) and the chronic steroid group 5/35 (14.3%). Conclusions: Percutaneous endoscopic gastrostomy tube placement may be safely performed in patients receiving corticosteroids both acutely and chronically with complication rates comparable to those patients not receiving steroid medications.