Predictive Factors for Percutaneous Endoscopic Gastrostomy in Patients with Spontaneous Intracranial Hemorrhage

Kiphuth, Ines C.; Kuramatsu, Joji B.; Lücking, Hannes; Kloska, Stephan P.; Schwab, Stefan; Huttner, Hagen B.

doi:10.1159/000322735

Cited by 16 publications

(11 citation statements)

References 99 publications

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“…172 In another German study of 208 ICH patients, 25% of patients required percutaneous endoscopic gastrostomy. 173 In this study, GCS, occlusive hydrocephalus, mechanical ventilation, and sepsis were independent risk factors for dysphagia and percutaneous endoscopic gastrostomy placement. In a prospective multicenter study, use of a formal screening protocol for dysphagia (eg, water swallow test) for all patients admitted with ischemic stroke was associated with a significantly reduced risk of pneumonia compared with no formal screen (OR, 0.10; 95% CI, 0.30-0.45).…”

mentioning

confidence: 55%

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Hemphill¹,

Greenberg²,

Anderson³

et al. 2015

Stroke

2,890

1,196

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2032Purpose-The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of spontaneous intracerebral hemorrhage. Methods-A formal literature search of PubMed was performed through the end of August 2013. The writing committee met by teleconference to discuss narrative text and recommendations. Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Oversight Committee and Stroke Council Leadership Committee. Results-Evidence-based guidelines are presented for the care of patients with acute intracerebral hemorrhage. Topics focused on diagnosis, management of coagulopathy and blood pressure, prevention and control of secondary brain injury and intracranial pressure, the role of surgery, outcome prediction, rehabilitation, secondary prevention, and future considerations. Results of new phase 3 trials were incorporated. Conclusions-Intracerebral hemorrhage remains a serious condition for which early aggressive care is warranted.These guidelines provide a framework for goal-directed treatment of the patient with intracerebral hemorrhage.

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mentioning

confidence: 55%

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Hemphill¹,

Greenberg²,

Anderson³

et al. 2015

Stroke

2,890

1,196

View full text Add to dashboard Cite

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“…In the present study, over 40% of patients still did not receive PEG placement but received nasogastric tube feeding 3 months after stroke onset, whereas severely dysphagic patients undergo PEG placement in a few weeks after onset in many Western countries [4,10,11,14,29,30]. Although the true reason for this is unclear, several factors may be involved.…”

Section: All Patientsmentioning

confidence: 73%

Acquisition of oral intake in severely dysphagic patients with acute stroke: A single-center, observational study involving a database of 4972 consecutive stroke patients

Nakajima

Inatomi

Yonehara

et al. 2012

Journal of the Neurological Sciences

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“…The older the patients, the more likely they were to be excluded because of a severely reduced state of consciousness [2]. In a recent study by Kiphuth et al [32], neurocritical care patients with spontaneous intracerebral hemorrhage were investigated searching for predictors of later percutaneous endoscopic gastrostomy (PEG) tube placement. Their results partly go along with ours because besides lobar hemorrhages with increasing volume, there was no other hematoma site, and especially not hematoma volume, which was associated with PEG tube placement.…”

Section: Discussionmentioning

confidence: 99%

Dysphagia in patients with acute striatocapsular hemorrhage

Suntrup

Warnecke

Kemmling³

et al. 2011

J Neurol

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Dysphagia is found in up to 80% of acute stroke patients. To date most studies have focused on ischemic stroke only. Little is known about the incidence and pattern of dysphagia in hemorrhagic stroke. Here we describe the characteristics of dysphagia in patients with striatocapsular hemorrhage. Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was carried out in 30 patients with acute striatocapsular hemorrhage. Dysphagia was classified according to the six-point Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) within 72 h after admission. Lesion volume, hemisphere and occurrence of ventricular rupture were determined from computer tomography scans. Data on initial NIH-SS, clinical symptoms, need for endotracheal intubation, diagnosis of pneumonia and feeding status on discharge were recorded. Swallowing impairment was observed in 76.7% of patients (n = 23). Mean FEDSS score was 3.1 ± 1.5. Main findings were penetration or aspiration of liquids as well as leakage to valleculae and piriform sinus. Incidence of pneumonia was 30.0% (n = 9). Age, NIH-SS and hematoma volume did not correlate with dysphagia severity. None of the clinical characteristics was predictive for dysphagia. On discharge after 12.9 ± 5.3 days, a two-point improvement on the FEDSS was seen in seven patients, (30.4%) and five patients (21.7%) had gained at least one point. In striatocapsular hemorrhage, dysphagia is a common and so far underrecognized symptom. FEES results indicate predominant impairment of oral motor control. Swallowing impairment is not related to other clinical deficits, stroke severity or lesion characteristics. Thus, detailed dysphagia assessment is indicated in all cases.

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Predictive Factors for Percutaneous Endoscopic Gastrostomy in Patients with Spontaneous Intracranial Hemorrhage

Abstract: GCS, occlusive hydrocephalus, mechanical ventilation, and systemic sepsis as independent risk factors for PEG tube placement. Conclusion: Disease severity and neurocritical care complications represent the major influencing parameters for PEG tube placement in spontaneous ICH patients.

Cited by 16 publications

References 99 publications

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Acquisition of oral intake in severely dysphagic patients with acute stroke: A single-center, observational study involving a database of 4972 consecutive stroke patients

Dysphagia in patients with acute striatocapsular hemorrhage

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