Nakajima M, Inatomi Y, Yonehara T, Hashimoto Y, Hirano T, Uchino M.
Intern Med. 2012;51(1):45-50. Epub 2012 Jan 1.
It remains unclear which patients with acute stroke need percutaneous endoscopic gastrostomy (PEG) placement and when it should be performed. The aim of this study was to identify the predictors for oral intake 6 months after onset in stroke patients.
Data were obtained from a prospectively registered database of 738 acute ischemic stroke patients both with and without a history of stroke. Patients who survived for 6 months and replied to a questionnaire were divided into two groups: those with oral intake 6 months after onset and those without. Predictors for oral intake 6 months after onset were analyzed.
Forty-five patients died during their hospital stay, 145 did not reply to the questionnaire, and 23 died during follow-up. Of the residual 525 patients, 485 (92.4%) had oral intake after 6 months. On multivariate analysis, modified Rankin Scale score 0 before admission (OR 2.70, 95% CI 1.10-6.61) and National Institutes of Health Stroke Scale (NIHSS) score ≤9 on day 10 (OR 21.12, 95% CI 5.04-88.39) were independent predictors for oral intake after 6 months, while NIHSS score on admission was not.
Clinicians should be cautious about PEG placement for stroke patients who were independent prior to their stroke and whose stroke severity decreases 10 days after admission, because their swallowing dysfunction may improve within a brief period.