Predictive factors for removal of percutaneous endoscopic gastrostomy tube in post-stroke dysphagia

Abstract

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.