Article

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.

Langue : ANGLAIS