Response

摘要

We are grateful for your interest in our study on risk factors for complications after PEG.As you have pointed out, there seems to be a connection between high CRP levels and low albumin levels regarding a generally worse outcome and prognosis in different areas of surgery. The results of our study do not prove that high CRP levels combined with low albumin levels substantially increases short-term mortality, because it is theoretically possible that patients with such measures are at an increased risk of mortality independent of the PEG tube insertion. It is, however, unlikely that many patients referred for PEG would have such a short life expectancy without this procedure. Nevertheless, we do believe that high CRP levels combined with low albumin levels should act as an easily available clinical warning signal of vulnerability to surgery. The surgical procedure of a PEG tube insertion is not an acute operation and usually could be postponed, during which time an attempt at mitigating an underlying acute disease could be tried. Other common means of nutritional support could be used in the meantime, for example, parenteral nutrition or nasogastric catheter.