Effects of Percutaneous Endoscopic Gastrostomy in Patients With Huntington Disease

Abstract

Abstract: Objective: To determine the impact of Percutaneous Endoscopic Gastrostomy (PEG) tubes in patients with advanced Huntington9s Disease (HD). Methods: A retrospective chart review of patients with HD was conducted to assess pneumonia and pressure ulcer rate, length of life, changes in weight and serological nutritional measures. Surviving and deceased patients with and without PEG tubes were compared using descriptive statistical analysis. Results: 148 records were reviewed (39 patients with PEG). The mean age of patients living with HD was 58.3 years ±12.7 years and age at death (n=62) 57.7 years ±10.3 years. At the time of analysis, mean duration of HD was 14.2 years ±7 years. Groups were similar in gender, age, and weight at admission. In those deceased, insertion of a PEG tube increased length of life with HD by 3.6 years (16.2 ±6.7 vs. 13.2 ±4.9 years). PEG placement significantly reduced cholesterol levels, increased prevalence of skin ulcers and rate of pneumonia. Insertion of a PEG tube did not significantly change weight or albumin levels. Conclusions: PEG tube placement in advanced HD provided benefit in length of life, but weight, other nutritional measures and rate of pneumonia were either not impacted or worsened with the insertion of a PEG tube. Impact on quality of life needs further study, but providers, patients and families should consider all options when discussing preferences for interventions. Classification of Evidence: This study provides Class IV evidence that for patients with advanced HD PEG tube placement increases length of life but has no or negative impacts on nutritional measures.