Percutaneous endoscopic gastrostomy reduces total hospital costs in head-injured patients

Background: Gastrostomies provide reliable long-term enteral access in patients with traumatic brain injuries. The impact of technique of gastrostomy on total hospital cost is not known. Methods: A retrospective analysis of patients who sustained head trauma and required gastrostomies for long-term enteral access between 1 July 1990 and 1 July 1996 was performed. Results: The patients who received percutaneous endoscopic gastrostomies (PEG) were similar to patients who received Stamm gastrostomies (OPEN) with respect to age, injury severity score, mechanism of injury, associated injuries, complication rates, and deaths. Total hospital costs ($ × 103) were lower for patients who had PEGs placed in the intensive care unit (78.2 ± 37.4) or endoscopy suite (71.9 ± 37.7) compared with PEGs placed in the operating room (122.4 ± 75.7) or OPEN gastrostomies (119.8 ± 65.1). Conclusions: In head-injured patients, PEGs are a reliable method of obtaining long-term enteral access with a complication rate equivalent to Stamm gastrostomies. If performed in either the intensive care unit or the endoscopy suite, PEGs are associated with significantly reduced total hospital costs.