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.
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