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New model for predicting surgical feeding tube placement in patients with an acute stroke event
Perry H Dubin1, Amelia K Boehme, James E Siegler
1From the Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA (P.H.D., J.E.S., A.S., J.J., S.M.-S.); Doris Duke Charitable Foundation, Clinical Research Fellow, New York, NY (P.H.D.); Department of Epidemiology (A.K.B., K.C.A.), and Department of Neurology (A.K.B.), University of Alabama at Birmingham, AL; Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, AL (K.C.A.); and Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC), University of Alabama at Birmingham, AL (K.C.A.).
Background And Purpose:
The need for surgical feeding tube placement after acute stroke can be uncertain and associated with further morbidity.
Methods:
Retrospective data were recorded and compared across patients with acute ischemic stroke and intracerebral hemorrhage. We identified all feeding tubes placed as percutaneous endoscopic gastrostomy (PEG) tubes. A prediction score for PEG tube placement was developed separately for patients with acute ischemic stroke and intracerebral hemorrhage using logistic regression models of variables known by 24 hours from admission.
Results:
Of 407 patients included, 51 (12.5%) underwent PEG tube placement (25 acute ischemic stroke and 26 intracerebral hemorrhage). The odds of a patient with acute ischemic stroke with PEG score ≥3 of getting a PEG are greater than those with PEG score <3 (odds ratio, 15.68; 95% confidence interval, 4.55-54.01). The odds of a patient with intracerebral hemorrhage with PEG score ≥3 of getting a PEG are greater than those with PEG score <3 (odds ratio, 12.49; 95% confidence interval, 1.54-101.29).
Conclusions:
The PEG score, comprised by variables known within the first day of admission, may be a powerful predictor of PEG placement in patients with acute stroke.
