Abstract Details

Title Predictors of Surgical Feeding Tube Placement after Acute Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 045

Objective

Background BACKGROUND: PEG placement often follows acute stroke and may be associated with more severe stroke and graver patient outcomes.

Design/Methods DESIGN/METHODS: We conducted a retrospective analysis of consecutive patients admitted within 24 hours of acute stroke to our center between 07/08 and 12/10. We compared admission and discharge data in patients that required PEG during hospital stay with those who did not. We also analyzed the differences between acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). Our primary outcome was PEG or other surgical feeding tube placement.

Results RESULTS: Of 711 screened patients, 76 underwent PEG placement. PEG placement was associated with black race (p=0.0051), earlier emergency department arrival (p=0.0079), higher admission National Institutes of Health Stroke Scale (NIHSS) Score (19 vs. 6, p<0.0001), dysarthria (p<0.001), and impaired level of consciousness (p<0.0001). Patients with PEG placement had a greater likelihood of tracheostomy (p<0.0001), increased length of stay (21 vs. 5 days; p<0.0001), poor discharge disposition (to a place other than home or inpatient rehabilitation, p<0.0001), increased discharge modified Rankin Scale (5 vs. 3; p<0.0001), and neurological deterioration during stay (defined as an increase in NIHSS ?2-points in 24hrs, p<0.0001). PEG in AIS patients was associated with anterior cerebral artery (p=0.0080), middle cerebral artery (p=0.0002), and cortical stroke (p<0.0001). PEG in ICH patients trended towards an association with supratentorial hemorrhage (p=0.0513). There was no association between PEG placement and age, intravenous tissue plasminogen activator use, or presence of vascular risk factors.

Conclusions CONCLUSIONS: Our study suggests that admission findings may be indicative of impending PEG placement. Further, PEG placement was found to be associated with significantly worse functional and neurological outcomes.

Authors/Disclosures
PRESENTER	No disclosure on file
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.
Laurie A. Schluter, RN, MSN, FNP (NP Health Solutions)	No disclosure on file
James E. Siegler III, MD (University of Chicago)	Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.
Amir Shaban, MD (University of Iowa)	Dr. Shaban has nothing to disclose.
	No disclosure on file
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
Sheryl Martin-Schild, MD, PhD, FAAN (Dr. Brain, Inc.)	No disclosure on file
Klaus Seppi, MD	Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ONO . Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIAL. Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie. Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bial. Dr. Seppi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. The institution of Dr. Seppi has received research support from MJFF. The institution of Dr. Seppi has received research support from EU. The institution of Dr. Seppi has received research support from FWF Austrian Science Fund,.

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