Audit of percutaneous endoscopic gastrostomy (PEG): a questionnaire survey of hospital consultants

One of the commonest indications for PEG is nutritional support in dysphagia. We investigated the current practice of PEG insertion in South Wales (UK). A postal questionnaire was sent to hospital consultants with responsibility for acute medical/geriatric intake in the South Wales area. Eighty-eight of 114 (78.5%) responded. In 69 of 107 (65%) responses (Radiologists and Geriatricians also performed PEG in some hospitals) Gastroenterologists performed the insertion of PEG. Seventy-one (87%) always involved speech therapists before PEG insertion. Forty-five (55%) and 47 (57%) always involved dieticians and nurses, respectively. Eighty (92%) involved carers before PEG. Sixty-three (76%) used nasogastric feed for nutritional support before PEG. Thirty-six of 80 (45%) responses would wait more than 2 weeks before inserting PEG (range less than 7 days to more than 6 weeks). Five (6.5%) preferred long-term nasogastric feed to PEG. Twenty-five (30%) had definite knowledge of a PEG clinic in their hospital and 38 of 77 (49%) who responded to this question said there was no routine follow-up or were not aware about follow up of PEG patients. There is wide variation in the timing of PEG insertion and involvement of paramedical staff. More research needs to be undertaken to provide evidence so guidelines can be developed in this area. Follow up of patients with PEG is poor but current evidence suggests follow up of these patients may be worth while as some patients with dysphagic stroke can regain their swallow late.