A multicenter comparative study of clinical and nursing outcomes: Percutaneous endoscopic versus radiologic gastrostomy

Abstract

Background:
Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are established routes for long-term enteral nutrition. Comparative studies commonly emphasize technical success and complications, while downstream care intensity and caregiver burden are less well quantified.


Methods:
We conducted a retrospective comparative cohort study of patients who underwent PEG versus PRG at three tertiary care centers, between January 2021 and January 2025. Propensity score matching (1:1) was used to reduce selection bias, and the primary comparative analyses were performed in the matched cohort. Outcomes included technical success, procedure duration, 30-day complications, nutritional recovery, tube-care nursing interventions within 30 days, caregiver burden (Zarit Burden Interview, ZBI), and caregiver satisfaction (5-point Likert scale).


Results:

After matching, 84 patients (42 per group) were analyzed. Technical success was comparable (PEG 98.7% vs. PRG 95.2%,
P
= 0.341), while procedure duration was shorter with PRG (22.1 ± 5.8 vs. 28.4 ± 6.5 min,
P
< 0.001). Thirty-day complications (16.7% vs. 21.4%,
P
= 0.541) and nutritional recovery (albumin at 1 month: 3.4 ± 0.4 vs. 3.3 ± 0.5 g/dL,
P
= 0.472; 4-week weight gain: 1.9 kg [1.0–2.7] vs. 1.8 kg [1.2–2.5],
P
= 0.715) were similar. PRG required more nursing interventions (6.1 ± 2.0 vs. 4.2 ± 1.3,
P
< 0.001). Caregiver burden was lower with PEG (ZBI 21.6 ± 5.2 vs. 26.4 ± 6.8,
P
= 0.002), and satisfaction scores were higher (mean ± standard deviation: 4.2 ± 0.9 vs. 3.4 ± 1.1,
P
= 0.001).



Conclusion:
PEG and PRG are both effective options for long-term enteral nutrition. Although PRG offers shorter procedure duration, PEG is associated with lower postprocedure care intensity and better caregiver-reported outcomes. Findings for complication rates are exploratory and hypothesis-generating and require confirmation in larger prospective studies.