Ann Rehabil Med.  2014 Aug;38(4):467-475. 10.5535/arm.2014.38.4.467.

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

• Crisan D
• Shaban A
• Boehme A
• Dubin P
• Juengling
• Schluter L
• Albright K
• Beasley TM
• Martin-Schild S

• KMID: 2165729
• DOI: http://doi.org/10.5535/arm.2014.38.4.467

Abstract

OBJECTIVE
To 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.
METHODS
A 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.
RESULTS
Patients 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).
CONCLUSION
Younger 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.

Keyword

Gastrostomy; Acute ischemic stroke; Rehabilitation; Dysphagia

MeSH Terms

Deglutition
Deglutition Disorders*
Demography
Gastrostomy*
Health Care Costs
Humans
Inpatients*
Pilot Projects*
Prospective Studies
Rehabilitation*
Retrospective Studies
Stroke*
Unnecessary Procedures

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