The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment and high loss to follow-up).
A Cochrane review included 9 RCTs with a total of 314 subjects to evaluate the effectiveness and safety of PEG as compared to NGT for adults with swallowing disturbances. The underlying conditions include motor neuron disease and multiple sclerosis; physical obstruction to swallowing, such as oesophageal tumours; an inability to ingest food due to head injury or stroke; and those with anorexia due to an underlying disease such as chronic lung disease, irritable bowel disease, or cancer.
| Outcome | Number of participants (studies) | Assumed risk (nasogastric tube) | Corresponding risk (percutaneous endoscopic gastrostomy) | Relative effect (95% CI) |
|---|---|---|---|---|
| Treatment failure | 314 (7) | 40 per 1000 | 10 per 1000 (3 to 30) | RR 0.24 (0.08 to 90.76) |
| Mortality | 584 (8) | 36 per 1000 | 34 per 1000 (23 to 51) | RR 0.96 (0.64 to 1.44) |
| Pneumonia | 585 (6) | 39 per 1000 | 33 per 1000 (24 to 45) | RR 0.84 (0.61 to 1.14) |
| Complications | 503 (5) | 43 per 1000 | 43 per 1000 (39 to 47) | RR 1.00 (0.91 to 1.11) |
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