Prevalence of Percutaneous Endoscopic Gastrostomy in Nursing Home Residents – A Nationwide Survey in Germany

Background: Despite extensive discussion about percutaneous endoscopic gastrostomy (PEG) in nursing home residents, no prevalence data exist in most countries. Objective: This study aimed to determine the prevalence of PEG in German nursing homes, as well as nursing home characteristics that may influence this prevalence. Additionally, we documented the timing of PEG insertion, whether pre- or postadmission to the nursing home, and the proportion of residents receiving oral nutrition in addition to tube feeds. Methods: A 26-item questionnaire was sent to 6,995 German nursing homes. Responses were anonymous. Results: Of the 6,995 questionnaires sent out, 807 (11.5%) were completed and returned. Of the 66,507 total residents in the responding nursing homes, there were 4,390 residents with PEG (6.6%). The median PEG prevalence was 5.6% (5th–95th percentile 1.0–16.3%). Of all PEGs inserted, 55.3% were inserted before and 44.7% were inserted after nursing home admission. Oral beverage intake in addition to tube feeding was reported in 48.8% of residents with a PEG, and 43.5% of patients also received solid food. There were no significant differences in PEG prevalence between the federal states of Germany. The location (rural vs. urban) of the nursing home, its proprietor and food delivery method had no significant influence on PEG prevalence. With regard only to PEG tubes inserted after nursing home admission, all the factors stated above showed no significant influence on PEG prevalence. Weak positive correlations between PEG prevalence and the size of the nursing home as well as the number of total and certified nursing staff per resident could be detected, reflecting the heavy burden of care associated with residents requiring artificial nutrition. Conclusions: Compared to other countries, Germany can be assumed to have an average PEG prevalence in nursing home residents. No specific nursing home characteristics could be identified that affect PEG prevalence