PEG-Related Complications and One-Year Survival in Patients with Neurological Disorders: A Retrospective Cohort Study

Background: Percutaneous endoscopic gastrostomy (PEG) is widely used for long-term enteral nutrition in patients with neurological disorders and persistent dysphagia. However, complication rates and post-PEG survival vary considerably according to patient characteristics and disease burden. This study evaluated PEG-related complications, one-year overall survival, and baseline predictors of these outcomes. Methods: This retrospective single-center cohort study included 276 consecutive adults with neurological disorders who underwent PEG placement at Mersin City Training and Research Hospital between January 2017 and December 2025. PEG-related complications were assessed throughout available follow-up. Multivariable logistic regression was used to identify independent predictors of complications. One-year overall survival was estimated using the Kaplan–Meier method, and a prespecified multivariable Cox proportional hazards model evaluated associations between age, sex, C-reactive protein (CRP), albumin, and one-year mortality. Results: PEG-related complications occurred in 76 patients (27.5%). The most frequent complications were PEG-site discharge (26.3%), tube dislodgement (25.0%), tube obstruction (14.5%), PEG-site bleeding (11.8%), and tube migration (10.5%). Increasing age was independently associated with lower odds of PEG-related complications (OR per 10-year increase, 0.758; 95% CI, 0.634–0.908; P=.003). Sex, CRP, and albumin were not independently associated with complications. During available follow-up, 75 patients (27.2%) died. Among patients with evaluable death dates, 63 deaths occurred within 365 days, and estimated one-year overall survival was 76.4%. None of the prespecified baseline variables independently predicted one-year mortality. Conclusions: PEG-related complications occurred in more than one-quarter of neurological patients, while approximately three-quarters survived one year. Age was independently associated with complications, whereas the evaluated baseline variables did not independently predict one-year mortality. Individualized clinical assessment remains essential in neurological patients undergoing PEG. Keywords: percutaneous endoscopic gastrostomy; PEG-related complications; neurological disorders; one-year survival; mortality; C-reactive protein; albumin