Impact of severe dysphagia on overall survival after percutaneous endoscopic gastrostomy.

Abstract

In this study, we investigated the effect of severe dysphagia on the overall survival of patients who underwent PEG. A cohort of patients who underwent PEG between April 2016 and April 2021 was retrospectively analyzed. The Hyodo-Komagane score was used to evaluate swallowing via endoscopy. Patients with a Hyodo-Komagane score ≤ 8 were defined as having moderate dysphagia, whereas those with a score ≥ 9 were defined as having severe dysphagia. The primary outcome was overall survival. The prognostic factors were identified using multivariate analysis with the Cox proportional hazards model. Values of p < 0.05 were considered statistically significant. Among the 107 patients, 60 (56.1%) were classified into the moderate dysphagia group and 47 (43.9%) into the severe dysphagia group. The median follow-up period was 16.7 months. The overall survival was significantly worse in the severe group than in the moderate group (p < 0.0001). A multivariate analysis revealed that severe dysphagia was an independent poor prognostic factor (hazard ratio, 2.956; 95% confidence interval, 1.592-5.489; p < 0.001). Aspiration-related pneumonia was most common causes of death after PEG. Severe dysphagia was identified as an independent poor prognostic factor for survival in patients who underwent PEG.