{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:53:40Z","timestamp":1793836420570,"version":"4.6.1"},"reference-count":14,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) is a widely accepted method for long-term enteral nutrition, but procedure-related complications and early mortality remain major concerns. Nutritional and inflammatory indices such as serum albumin, C-reactive protein (CRP), Prognostic Nutritional Index (PNI), and Nutrition Risk Screening (NRS-2002) may provide prognostic value, yet comparative data in PEG cohorts are limited. This study aimed to identify predictors of complications and 90-day mortality after PEG and to compare the prognostic performance of nutritional indices. Materials and Methods: A retrospective cohort of 122 consecutive adult patients undergoing PEG between January and December 2024 was analyzed. Demographic, clinical, and laboratory parameters were collected, including albumin, CRP, PNI, and NRS-2002. Complications were categorized as early (\u226430 days) or late (&gt;30 days), and all-cause mortality was assessed at 30 and 90 days. Univariate and multivariate logistic regression models were used to evaluate predictors of complications and 90-day mortality. To address multicollinearity, albumin, PNI, and NRS-2002 were separately tested in adjusted models, with model performance assessed by AIC, BIC, Nagelkerke R2, and C-index. Results: Early complications occurred in 4.9% and late complications in 8.2% of patients, for a total complication rate of 13.1%. Thirty-day mortality was 4.1%, 90-day mortality 17.2%, and total in-hospital mortality during the study year 30.3%. Neuromuscular indication was independently associated with increased risk of complications (aOR 5.0, 95% CI 1.2\u201320.0, p = 0.028) but reduced 90-day mortality (aOR 0.15, 95% CI 0.03\u20130.80, p = 0.025). Lower baseline albumin independently predicted higher 90-day mortality (aOR 0.92, 95% CI 0.86\u20130.99, p = 0.034). Elevated CRP demonstrated a borderline association with mortality (p = 0.051), while NRS-2002 \u22655 and \u0394-PNI showed borderline trends toward increased mortality risk. In model comparison, none of the nutritional indices achieved independent statistical significance, but all demonstrated similar performance (AIC = 114, C-index 0.72\u20130.74). Conclusions: PEG outcomes are strongly influenced by baseline indication and nutritional\u2013inflammatory status. Neuromuscular patients and patients with dysphagia face higher complication risk but lower short-term mortality, while hypoalbuminemia, elevated CRP, and high NRS-2002 or declining PNI identify patients at greater risk of death. Systematic integration of albumin, CRP, PNI, and NRS-2002 may improve risk stratification and management in PEG candidates.<\/jats:p>","DOI":"10.3390\/medicina61111916","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T02:50:48Z","timestamp":1761533448000},"page":"1916","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk Factors for Complications and 90-Day Mortality After Percutaneous Endoscopic Gastrostomy: The Role of Nutritional and Inflammatory Markers"],"prefix":"10.3390","volume":"61","author":[{"given":"Nermin","family":"Mutlu Bilgi\u00e7","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, \u00dcmraniye Training and Research Hospital, University of Health Sciences, Istanbul 34000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcldan","family":"Kahveci","sequence":"additional","affiliation":[{"name":"Department of Nutritional Nursing, \u00dcmraniye Training and Research Hospital, University of Health Sciences, Istanbul 34000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-8115","authenticated-orcid":false,"given":"H\u00fcseyin","family":"Aykut","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u00dcmraniye Training and Research Hospital, University of Health Sciences, Istanbul 34000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin","family":"\u00d6zer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u00dcmraniye Training and Research Hospital, University of Health Sciences, Istanbul 34000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3797-5648","authenticated-orcid":false,"given":"Ekmel Burak","family":"\u00d6z\u015fenel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u00dcmraniye Training and Research Hospital, University of Health Sciences, Istanbul 34000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sema","family":"Basat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u00dcmraniye Training and Research Hospital, University of Health Sciences, Istanbul 34000, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bilgi\u00e7, N.M., Kahveci, G., \u00d6z\u015fenel, E.B., and Basat, S. (2025). One-Year Mortality After Percutaneous Endoscopic Gastrostomy: The Prognostic Role of Nutritional Biomarkers and Care Settings. Nutrients, 17.","DOI":"10.3390\/nu17050904"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.62210\/ClinSciNutr.2024.89","article-title":"Complications and factors associated with mortality in patients undergoing percutaneous endoscopic gastrostomy","volume":"6","author":"Seyhan","year":"2024","journal-title":"Clin. Sci. Nutr."},{"key":"ref_3","first-page":"529","article-title":"Percutaneous endoscopic gastrostomy: An update on its indications, management, complications, and care","volume":"106","author":"Lucendo","year":"2014","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1093\/qjmed\/hcy137","article-title":"Prognostic nutritional index and early mortality with percutaneous endoscopic gastrostomy","volume":"111","author":"Adachi","year":"2018","journal-title":"QJM Int. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pei, R., and Wang, D. (2025). Prognostic nutritional index negative associated with mortality in older Japanese patients with dysphagia. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1586248"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"283","DOI":"10.51821\/84.2.283","article-title":"Predictive factors of complications and 30-day mortality in patients undergoing percutaneous endoscopic gastrostomy: The utility of C-reactive protein to albumin ratio","volume":"84","author":"Duzenli","year":"2021","journal-title":"Acta Gastro Enterol. Belg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Stenberg, K., Eriksson, A., Odensten, C., and Darehed, D. (2022). Mortality and complications after percutaneous endoscopic gastrostomy: A retrospective multicentre study. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02429-0"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Miyasato, Y., Hanna, R.M., Morinaga, J., Mukoyama, M., and Kalantar-Zadeh, K. (2023). Prognostic nutritional index as a predictor of mortality in 101,616 patients undergoing hemodialysis. Nutrients, 15.","DOI":"10.3390\/nu15020311"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.gie.2010.09.012","article-title":"Albumin and C-reactive protein levels predict short-term mortality after percutaneous endoscopic gastrostomy in a prospective cohort study","volume":"73","author":"Blomberg","year":"2011","journal-title":"Gastrointest. Endosc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/jgh.14407","article-title":"Risk factors for early and late procedure-related adverse events in percutaneous endoscopic gastrostomy: A single center, retrospective study","volume":"34","author":"Osman","year":"2019","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_11","first-page":"891","article-title":"Malnutrition is an independent risk factor of early complications following percutaneous endoscopic gastrostomy","volume":"25","author":"Beau","year":"2001","journal-title":"Gastroenterol. Clin. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Pih, G.Y., Na, H.K., Ahn, J.Y., Jung, K.W., Kim, D.H., Lee, J.H., Choi, K.D., Song, H.J., Lee, G.H., and Jung, H.-Y. (2018). Risk factors for complications and mortality of percutaneous endoscopic gastrostomy insertion. BMC Gastroenterol., 18.","DOI":"10.1186\/s12876-018-0825-8"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4274\/ejgg.galenos.2022.2022-9-1","article-title":"Impact of Malnutrition Status at Admission on Post-discharge Short Term Mortality in Palliative Care Unit","volume":"5","author":"Deniz","year":"2023","journal-title":"Eur. J. Geriatr. Gerontol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Evirgen, S., and Cetin, S. (2025). The Predictive Value of Preoperative C-Reactive Protein to Albumin Ratio (CAR), Neutrophil to Lymphocyte Ratio (NLR), and Platelet to Lymphocyte Ratio (PLR) for Early Postoperative Complications Following PEG. Complications, 2.","DOI":"10.3390\/complications2030016"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/1916\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T03:30:57Z","timestamp":1761535857000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/1916"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,25]]},"references-count":14,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["medicina61111916"],"URL":"https:\/\/doi.org\/10.3390\/medicina61111916","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,25]]}}}