30 - Early vs Delayed Feeding After Percutaneous Endoscopic Gastrostomy Tube Placement - Systematic Review and Meta-Analysis

Eric Smith, MD¹, Mahesh Gajendran, MD, MPH², Chandraprakash Umapathy, MD^3
1Baylor Scott and White, Houston, TX; ²UTHSCSA, San Antonio, TX; ³University of Texas Health San Antonio, San Antonio, TX

Introduction: In clinical practice, tube feedings have been delayed after the percutaneous endoscopic gastrostomy (PEG) tube placement. Previous studies including a meta-analysis in 2008 showed that it is safe to start tube feeding within 4 hours of PEG tube placement. However, it is still a common practice to delay initiation of tube feeding up to 24 hours after PEG tube placement. We have performed an updated analysis of studies comparing early and late tube feedings.

Methods: Major databases like PubMed, EMBASE, and Web of Science were searched in June 2022 for randomized controlled trial (RCT) studies reporting on outcomes comparing early (< or = 4 hours) vs delayed ( >4 hours) feeding after PEG tube placement in adult patients. The primary outcomes in our study include complication rates and mortality rates within 72 hours of procedure. The outcomes were reported as pooled odds ratio (95% confidence interval [CI], p-value, I²).

Results: Seven RCT's that included 507 patients were analyzed. The pooled complication rate was 0.87 (95% CI 0.52 – 1.46, p= 0.57, I² = 0%). The pooled mortality rate was 0.58 (95% CI 0.19 – 1.74, p-0.33, I² = 0%). The pooled gastric residuals was 1.75 (95% CI 0.99 – 3.09, p = 0.05, I² = 0%), with more gastric residuals in the early feeding group. Of note, one study found that hospital stay was significantly decreased in early feeding (27 vs 33 hours, p< .001).

Discussion: This meta-analysis supports that the early feeding after PEG tube placement is as safe as delayed feeding and may shorten hospital stay.



Disclosures:


Eric Smith, MD¹, Mahesh Gajendran, MD, MPH², Chandraprakash Umapathy, MD³, 30, Early vs Delayed Feeding After Percutaneous Endoscopic Gastrostomy Tube Placement - Systematic Review and Meta-Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.