Palliative Care in the Community and the Relevance of Percutaneous Endoscopic Gastrostomy Placement to Quality of Life and Survival

Introduction: Percutaneous endoscopic gastrostomy (PEG) placement does not generate consensus in palliative care, given the existing doubts about whether it significantly contributes to an improvement in patient outcomes such as survival, quality of life and symptomatic control. Objective: This study explored the impact of percutaneous endoscopic gastrostomy placement on survival and quality of life in patients under community palliative care in Northern Portugal. Methods: This observational, retrospective cohort study involved 54 patients monitored by a specialized palliative care team between March 2020 and December 2023. The key outcomes assessed included the survival rates, the main diagnoses leading to PEG requests, and the influence of PEG placement on survival and the place of death. Results: The statistical analysis revealed that the survival time was significantly longer in females compared to males (p = 0.003). The main reason for PEG requests was dysphagia, especially in patients with dementia and oncological diseases. No significant correlations were found between PEG placement and the age at death, survival time, or palliative performance scores (PPS). However, the study identified a moderate positive correlation between the follow-up time and survival after PEG placement (r = 0.457, p < 0.001) and a low rate of complications (11% of patients with minor complications and none with severe complications). Conclusions: This study emphasizes the role of timely PEG placement and social support in improving patient outcomes. Additionally, patients whose PEG was requested by the study’s palliative care team demonstrated better survival outcomes compared to those referred by other teams. The findings underscore the need for individualized decision-making in PEG placement and suggest that this procedure is safe and increases patient longevity and quality of life, avoiding the high rate of complications associated with nasogastric tubes in fragile patients in need of specialized palliative care.