Predictors of Percutaneous Endoscopic Gastrostomy Tube Placement after Stroke.

AIMS: the goal of this study was to identify important prognostic variables affecting placement of a percutaneous endoscopic gastrostomy (Peg) tube after acute stroke.

METHODS

We retrospectively reviewed our patient database to identify acute ischemic stroke patients who placed Peg or nasogastric tube (NGT) tube, but were free of other confounding conditions affecting swallowing. A total of 340 patients were involved in our study. We assessed the influence of age, National Institutes of Health stroke scale (NIHSS) score, infarct volume, stroke subtype based on the toAst criteria, swallowing disorders, bilateral lesions in cerebrum and length of stay (los) in a logistic regression analysis.

RESULTS

In univariate analysis, age (p=0.048), NIHSS score (p<0.0001), lesion volume (p<0.0001), los (p<0.0001), stroke location (p=0.045), and swallowing disorders (p<0.0001) were found to be the primary predictors of placing Peg. the presence of lesions in bilateral cerebral was included in the final model based on clinical considerations. After multivariate adjustment, only NIHSS score (odds ratio [oR], 4.055; 95% confidence interval [CI], 2.398-6.857; p=0.0001), lesion volume (oR, 1.69; 95% CI, 1.09–4.39; p=0.014), swallowing disorders (oR, 1.151; 95% CI, 1.02-1.294; p=0.047), los (oR, 0.955; 95% CI, 0.914-0.998; p=0.0415) and bilateral lesions (oR, 2.8; 95% CI, 1.666-4.705; p=0.0001) remained significant.

CONCLUSION

our data shows that NIHSS score, lesion volume, swallowing disorders, los and bilateral lesions in cerebrum can predict the requiring of Peg tube insertion in patients after stroke.

UNLABELLED: Facteurs de prédiction de la mise en place d'un tube de gastrostomie par endoscopie percutanée après un accident vasculaire cérébral.