Predictors of feeding gastrostomy tube removal in stroke patients with dysphagia

Ickenstein, Guntram W.; Kelly, Peter; Furie, Karen L.; Ambrosi, Denise; Rallis, Nikoletta; Goldstein, Richard; Horick, Nora; Stein, Joel

doi:10.1016/s1052-3057(03)00077-6

Cited by 51 publications

(64 citation statements)

References 30 publications

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“…The study was approved by the hospital's institutional review board. An analysis of swallowing recovery during neurorehabilitation in this study population has previously been published [9].…”

Section: Methodsmentioning

confidence: 99%

“…■ Key words stroke · dysphagia · neurorehabilitation · stroke outcome · feeding tubes Introduction Stroke is the most common cause of neurogenic oropharyngeal dysphagia (NOD) in the population [27], and NOD may result in aspiration pneumonia, dehydration, malnutrition, and decreased functional independence [9]. In the population of stroke survivors receiving rehabilitation, dysphagia has been reported with an incidence up to 50 % [7].…”

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confidence: 99%

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Predictors of survival after severe dysphagic stroke

et al. 2005

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Severe dysphagia requiring FGT is common in patients with stroke referred for neurorehabilitation. Patients who had a FGT in place at the time of discharge from the stroke rehabilitation unit or aspirated during VSS were substantially more likely to have died by the time of follow-up compared to those who had had the FGT removed and had no signs of aspiration on VSS. However functional outcome measurements (FIM, FCM) including the cognitive function (attention, concentration etc.) could play an important role for prediction of swallowing regeneration and survival in neurorehabilitation. These findings may have practical utility in guiding physicians and speech language pathologists when advising patients and families about prognosis in stroke survivors with severe dysphagia.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Predictors of survival after severe dysphagic stroke

et al. 2005

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“…Variables that influence the recovery of swallowing function have not been well established. Bihemispheric infarcts, right hemisphere infarcts, dysarthria, intubation, the National Institute of Health Stroke Scale (NIHSS) ≥12, aspiration during videofluoroscopic swallowing study, and age greater than 52 years were significant predictors of persistent dysphagia [3,4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Predictors of Recovery of Functional Swallow After Gastrostomy Tube Placement for Dysphagia in Stroke Patients After Inpatient Rehabilitation: A Pilot Study

et al. 2014

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ObjectiveTo determine predictors of early recovery of functional swallow in patients who had gastrostomy (percutaneous endoscopic gastrostomy [PEG]) placement for dysphagia and were discharged to inpatient rehabilitation (IPR) after stroke.MethodsA retrospective study of prospectively identified patients with acute ischemic and hemorrhagic stroke from July 2008 to August 2012 was conducted. Patients who had PEG during stroke admission and were discharged to IPR, were studied. We compared demographics, stroke characteristics, severity of dysphagia, stroke admission events and medications in patients who remained PEG-dependent after IPR with those who recovered functional swallow.ResultsPatients who remained PEG dependent were significantly older (73 vs. 54 years, p=0.009). Recovery of swallow was more frequent for hemorrhagic stroke patients (80% vs. 47%, p=0.079). Age, adjusting for side of stroke (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.82-0.98; p=0.016) and left-sided strokes, adjusting for age (OR, 15.15; 95% CI, 1.32-173.34; p=0.028) were significant predictors of swallow recovery. Patients who recovered swallowing by discharge from IPR were more likely to be discharged home compared to those who remained PEG-dependent (90% vs. 42%, p=0.009).ConclusionYounger age and left-sided stroke may be predictive factors of early recovery of functional swallow in patients who received PEG. Prospective validation is important as avoidance of unnecessary procedures could reduce morbidity and healthcare costs.

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“…Clinically apparent dysphagia is present in up to 50% of patients following stroke [14][15][16]. Aspiration is a complication frequently associated with dysphagia, although at times it may occur with no obvious signs of the latter [14,17]. There is also increased dependence on healthcare services, morbidity (in the form of dehydration, malnutrition, and infection), and mortality associated with dysphagia, whether or not there is coexisting aspiration.…”

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confidence: 99%

Role of Cerebral Cortex Plasticity in the Recovery of Swallowing Function Following Dysphagic Stroke

Barritt

Smithard

2008

Dysphagia

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Effective swallowing is an essential part of life and is performed thousands of times per day, often without conscious consideration. Difficulty in swallowing (dysphagia) commonly arises in stroke patients following ischemia of the cerebral cortex. However, whereas this tends to resolve spontaneously in the majority of patients, a small percentage will be left with a persistent dysphagia, which predisposes to airway compromise and aspiration pneumonia. This article reviews the recent research into ways of restoring swallowing function in these patients through promoting plasticity and reorganisation of the remaining, viable cerebral cortex.

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Predictors of feeding gastrostomy tube removal in stroke patients with dysphagia

Cited by 51 publications

References 30 publications

Predictors of survival after severe dysphagic stroke

Predictors of survival after severe dysphagic stroke

Predictors of Recovery of Functional Swallow After Gastrostomy Tube Placement for Dysphagia in Stroke Patients After Inpatient Rehabilitation: A Pilot Study

Role of Cerebral Cortex Plasticity in the Recovery of Swallowing Function Following Dysphagic Stroke

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