Background and aims Patients with cirrhosis may require enteral access; however, the safety of percutaneous gastrostomy tube placement in this population remains unclear. We aimed to evaluate the safety of percutaneous gastrostomy tube placement in patients with compensated and decompensated cirrhosis compared with non-cirrhotic controls. Methods and results Study cohorts were identified using the TriNetX US Collaborative Network database. Adult individuals with cirrhosis who underwent percutaneous gastrostomy placement were categorized as having compensated or decompensated cirrhosis and compared with matched non-cirrhotic controls. We assessed 30-day post-procedural complications. A total of 160 893 patients without cirrhosis, 2279 patients with compensated cirrhosis, and 3564 patients with decompensated cirrhosis who underwent percutaneous gastrostomy placement were identified. After matching, patients with decompensated cirrhosis experienced significantly higher rates of percutaneous gastrostomy-related hemorrhage adjusted odds ratio (aOR) 2.37 (1.27–4.44), percutaneous gastrostomy malfunction aOR 1.68 (1.36–2.07), peritonitis aOR 13.67 (8.21–15.79), sepsis aOR 2.02 (1.74–2.34), perforation aOR 4.44 (2.23–8.84), and gastrointestinal bleeding aOR 2.99 (2.27–3.93) compared with non-cirrhotic controls. However, in the compensated group, there were no significant differences in all complications, except mortality, compared with non-cirrhotic controls. Conclusion In this large real-world cohort study, patients with decompensated cirrhosis were at higher risk of gastrostomy-related complications compared with non-cirrhotic controls. However, gastrostomy tube placement was found to be safe in patients with compensated cirrhosis. These findings highlight the importance of careful risk stratification and patient selection when considering gastrostomy tube placement in patients with cirrhosis.
Eldesouki et al. (Fri,) studied this question.