Predictive factors for removal of percutaneous endoscopic gastrostomy tube in post-stroke dysphagia
Youbin Yi, Eun Joo Yang, Juyong Kim, Woo Jin Kim, Yusun Min, Nam-Jong Paik
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea
Objective: To investigate predictive factors for percutaneous endoscopic gastrostomy (PEG) removal, thereby minimizing unnecessary PEG insertion in post-stroke dysphagia.
Design: Retrospective cohort study.
Patients: A total of 49 patients who undertook PEG tube insertion for post-stroke dysphagia
Methods: Patients were divided into a removal group (n = 8) and a sustaining group (n = 41) depending on the presence of a PEG tube. Patients’ demographic data, nutritional status, Charlson’s Comorbidity Index (CCI), and video-fluoroscopic
swallowing study findings at the time of PEG insertion were compared between the 2 groups.
Results: Eight out of 49 patients (16.3%) removed the PEG tube at a mean of 4.8 months after the insertion. Demographic data, nutritional status, and CCI were comparable between the 2 groups before tube insertion. Video-fluoroscopic swallowing study findings in the removal group showed a lower prevalence of premature bolus loss (50.0% vs 73.2%; p = 0.032), aspiration (37.5% vs 80.6%; p = 0.012) and pharyngeal trigger delay (12.5% vs 74.2%; p = 0.010) than those in the sustaining group.
Conclusion: The absence of aspiration or pharyngeal trigger delay in video-fluoroscopic swallowing study findings at the time of PEG insertion may be a predictive factor for eventual removal of PEG tubes. Identification of removal factors will assist in determining PEG insertion.
Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors.
You need to login/create an account to comment on articles. Click here to login/create an account