Affiliations: [a] Department of Neurology Hartford Hospital, Hartford, CT, USA | [b] Department of Neurology and Neurosciences, The University of Connecticut Health Center, Hartford, CT, USA | [c] The Stroke Center at Hartford Hospital, Hartford, CT, USA | [d] Jefferson Radiology, CT, USA | [e] Hartford Hospital Research Department, Hartford, CT, USA
Correspondence:
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Address for correspondence: Christa O'Hana V. San Luis, JB6 80 Seymour St., Hartford, CT 06102-5037, USA. Tel.: +1 949 8780490, +1 860 5455047; Fax: +1 860 5455003; E-mail: [email protected]
Abstract: Background:Prolonged dysphagia after middle cerebral artery (MCA) territory strokes may require percutaneous endoscopic gastrostomy (PEG) tube feeding. Objective:We examined the predictors of PEG placement among patients with MCA stroke. It was hypothesized that stroke laterality was a predictor. Methods:A retrospective cohort study of existing data from Hartford Hospital Stroke Database was done. A total of 157 patients with acute ischemic MCA stroke were included. Patients were divided into the “PEG” group (n = 24) and “no PEG” group (n = 133). Existing demographic, clinical and swallowing data were compared between the 2 groups. Results:Demographic data were similar between the groups. The “PEG” group had a higher admission National Institute of Health Stroke Scale (NIHSS) score, higher proportion of patients who had thrombolytic administration, in- hospital aspiration pneumonia and inability to be assessed on first swallow evaluation. Multivariate analysis revealed that all, except thrombolytic administration may predict PEG placement. Conclusion:Admission NIHSS score, in-hospital aspiration pneumonia and inability to undergo first swallow evaluation may predict PEG placement in patients with acute MCA stroke. Stroke laterality was not associated. This knowledge facilitates early identification of patients that may require PEG tube placement for early nutrition provision and discharge to rehabilitation.
