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Related Experiment Videos

Modified barium swallow does not affect how often PEGs are placed after stroke

B E Akpunonu1, A B Mutgi, C Roberts

  • 1Department of Internal Medicine, Medical College of Ohio, Toledo 43699, U.S.A.

Journal of Clinical Gastroenterology
|March 1, 1997
PubMed
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Modified barium swallows did not solely determine percutaneous endoscopic gastrostomy (PEG) placement after stroke. Clinical factors like neurological deficits and aspiration pneumonitis prevalence were more influential in decisions for feeding tube insertion.

Area of Science:

  • Neurology
  • Gastroenterology
  • Radiology

Background:

  • Dysphagia is a common complication following stroke, often leading to nutritional and hydration issues.
  • Percutaneous endoscopic gastrostomy (PEG) is utilized to manage dysphagia, aiming to improve nutrition, hydration, and reduce aspiration pneumonitis risk.

Purpose of the Study:

  • To assess the impact of modified barium swallow (MBS) on percutaneous endoscopic gastrostomy (PEG) placement decisions.
  • To investigate the influence of specific swallowing abnormalities on PEG placement after stroke.

Main Methods:

  • Retrospective review of 302 stroke patients admitted between 1989-1993.
  • Analysis included patients with confirmed stroke via CT/MRI/autopsy, excluding TIAs, tumors, and trauma.
  • Modified barium swallow studies were performed on 69 patients, assessing pharyngeal stasis, posterior pharyngeal transfer, and aspiration.

Related Experiment Videos

Main Results:

  • 49 of 69 MBS studies (71%) were abnormal.
  • PEG placement occurred in 18% of patients with abnormal MBS and 25% with normal MBS.
  • PEG placement was not directly correlated with specific MBS abnormalities but rather with significant neurological deficits and aspiration pneumonitis.

Conclusions:

  • Modified barium swallow findings alone were insufficient for deciding PEG placement in stroke patients.
  • Clinical assessment, including neurological status and aspiration risk, primarily guided PEG insertion decisions.
  • PEG placement decisions were based on comprehensive clinical evaluation rather than isolated imaging results.