P3389 - Outcomes of Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement in Patients With HIV Compared to Non-HIV

Nikhitha Mantri, MD¹, Haozhe Sun, MD², Sameer Datta Kandhi, MD³, Nishant Allena, MD², Shalini Penikilapate, MBBS², Vibha V. Hayagreev, MD³, Muhammad Yasir Anwar, MD², Siddharth Chinta, MD², Priscilla Lajara Hallal, MD⁴, Ahmed Alemam, MD², Harish Patel, FACG⁵, Jasbir Makker, MD, FACG^2
1Bronx Lebanon Hospital Center, Bronx, NY; ²BronxCare Health System, Bronx, NY; ³BronxCare Health System, New York, NY; ⁴BronxCare, Bronx, NY; ⁵BronxCare Hospital Center, Bronx, NY

Introduction: Percutaneous endoscopic gastrostomy (PEG) tube placement is a commonly performed procedure to provide adequate nutritional support to patients who cannot eat orally due to their medical illness. Although considered a safe procedure, it can lead to some minor and major complications. There is scarcity of data on the outcomes of PEG tube placement in HIV patients.

Methods: This is a single-center retrospective observational study involving patients with PEG tube placement. Demographic data, comorbidities, and laboratory parameters were extracted from their medical records. HIV status was determined either by a positive western blot or a documented HIV diagnosis in the medical record. Patients in whom HIV status could not be determined were excluded. Indications and complications including PEG site bleeding, cellulitis, abdominal infection, acute abdomen, post-PEG ileus, peritonitis and mortality were recorded. Primary outcomes, including mortality and other complications, were compared among the two groups: HIV and non-HIV.Binomial regression analysis was performed to assess the effect of HIV on the likelihood of having a complication.

Results: A total of 639 PEG tubes were placed during the study period (2006 - 2014). HIV testing was performed on 461 patients of which 85 patients (n=18%) tested positive. The HIV group had a younger patient population and significantly less patients with comorbid conditions like hypertension, diabetes mellitus, coronary artery disease. 99 patients (21.5%) died within 1 year of PEG tube placement, and 33 patients among these died within a month. 30 patients (6.5%) had major post PEG insertion site bleeding requiring more than 2 units of blood transfusion and 37 (8%) patients had other PEG related complications. HIV group had significantly higher mortality as compared to the non-HIV group, 37.6% vs 17.8% (p-value 0.001). Post-PEG insertion site bleeding in the HIV group (15.3%) was significantly higher (p-value 0.001) as compared to the non-HIV group (4.5%), without any significant difference in their anti-coagulation use. Binary logistic regression revealed significantly higher mortality and insertion site bleeding rates in the HIV group after controlling for confounding factors.

Discussion: HIV-positive patients with PEG tube placement are significantly younger than non-HIV patients, and they have significantly fewer other major comorbid conditions. Nevertheless, they have significantly higher rates of major PEG insertion site bleeding and mortality.


Disclosures:


Nikhitha Mantri, MD¹, Haozhe Sun, MD², Sameer Datta Kandhi, MD³, Nishant Allena, MD², Shalini Penikilapate, MBBS², Vibha V. Hayagreev, MD³, Muhammad Yasir Anwar, MD², Siddharth Chinta, MD², Priscilla Lajara Hallal, MD⁴, Ahmed Alemam, MD², Harish Patel, FACG⁵, Jasbir Makker, MD, FACG². P3389 - Outcomes of Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement in Patients With HIV Compared to Non-HIV, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.