Predictors of Percutaneous Endoscopic Gastrostomy Placement in Acute Ischemic Stroke

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Kristin BrownAnjail Sharrief

Abstract

Dysphagia is a common complication of stroke and can have a lasting impact on morbidity and mortality; yet there are no standards to guide dysphagia management in stroke patients. We assessed predictors of percutaneous endoscopic gastrostomy (PEG) placement in an ischemic stroke cohort and sought to determine the utility of an objective scale in predicting PEG placement in a high-risk sub-set. Consecutive cases of ischemic stroke were retrospectively, identified and demographic and clinical variables were collected. Penetration-Aspiration (PAS) scores (1-2 normal; 3-5 penetration; 6-8 aspiration) were calculated for patients undergoing Fiberoptic Endoscopic Evaluation of Swallowing (FEES) or Modified Barium Swallowing Studies (MBSS). Multiple logistic regression analysis was used to assess predictors of PEG placement. Among 724 patients, 131 underwent PEG placement. In univariate analysis of the overall cohort, sex, age, insured payer status, arrival National Institute of Health Stroke Scale (NIHSS), NIHSS level of consciousness severity, NIHSS dysarthria severity, diabetes mellitus, and prior International Conference for Harmonization (ICH) were all significantly associated with PEG placement. Among 197 high-risk patients unde...Continue Reading

Citations

Oct 16, 2019·Stroke; a Journal of Cerebral Circulation·Cathy M StinearWinston D Byblow
Mar 5, 2020·Annals of Rehabilitation Medicine·Ji Soo ChoiTai Ryoon Han
Dec 15, 2020·The Laryngoscope·Noah Z FeitAnaïs Rameau

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