Endoscopic gastrostomy for nutritional support in post-stroke dysphagia

Patita, Marta; Nunes, Gonçalo; Grunho, Miguel; Santos, Carla Adriana; Fonseca, Jorge

http://hdl.handle.net/10400.26/58732

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Authors

Patita, Marta

Nunes, Gonçalo

Grunho, Miguel

Santos, Carla Adriana

Fonseca, Jorge

Abstract(s)

Introduction: persistent dysphagia affects 15 % of stroke patients and contributes to malnutrition, aspiration, and death. This study aimed to characterize patients with post-stroke dysphagia who underwent percutaneous endoscopic gastrostomy (PEG), and to assess the impact of PEG feeding on nutritional status and outcome. Methods: an observational and retrospective study using records from patients with post-stroke dysphagia who underwent PEG. Body mass index (BMI), serum albumin, transferrin, and cholesterol were recorded at the time of PEG insertion (T0) and 3 months later (T3). The evolution of these parameters was analyzed and compared to survival. Results: we obtained data from 158 patients (53.2 % males) with a median age of 75 years. Most strokes were ischemic (n = 135, 85.4 %). Median time between stroke and PEG was 2 months. Median survival after gastrostomy was 16 months. At admission, 41.6 % of patients had low BMI, 62.3 % low albumin, 68.6 % low transferrin, and 59.6 % low cholesterol levels. The prevalence of low albumin and low transferrin was higher in the patients who underwent PEG more than 2 months after stroke. A significant increase in albumin and transferrin, and a normalization of cholesterol levels was observed after 3 months of PEG feeding. Mortality was 12.9 %, 27.7 %, and 40 % at 1, 3, and 12 months, respectively. Survival was lower in patients with low albumin, transferrin or total cholesterol at admission. Conclusions: the prevalence of malnutrition is high among patients with post-stroke dysphagia. PEG feeding improves albumin, transferrin, and cholesterol levels. Early post-PEG mortality is high and must be considered on an individual basis.

Keywords

stroke dysphagia nutrition gastrostomy

URI

http://hdl.handle.net/10400.26/58732

Citation

Patita M, Nunes G, Grunho M, Santos CA, Fonseca J. Endoscopic gastrostomy for nutritional support in post-stroke dysphagia. Nutr Hosp 2021;38(6):1126-1131. DOI: http://dx.doi.org/10.20960/nh.03147