A prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke

Bin Basri Hamidon, S. A. Abdullah, M. F. Zawawi, N. Sukumar, Amilia Aminuddin, Raymond Azman Ali

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Dysphagia following stroke is a common problem and is of particular concern because of its potential for malnutrition. Nasogastric (NG) and percutaneous endoscopic gastrostomy (PEG) tube feeding are recognized methods for nutritional support for patients with persistent neurologic dysphagia. However, the former is associated with tube dislodgement and blockage that might compromise the patients' nutritional status. There have been few randomized prospective studies to date comparing the efficacy and safety of these 2 modes of dysphagia management in stroke patients. The objective of this study was to compare PEG with NG tube feeding after acute dysphagic stroke in terms of nutritional status and treatment failure. This was a randomized prospective clinical trial. A total of 23 consecutive patients who fulfilled the criteria were recruited from the medical wards in Hospital Universiti Kebangsaan Malaysia. The diagnosis of stroke (acute cerebral infarct) was based on clinical and brain computed tomographic (CT scan) findings; and the diagnosis of dysphagia was done clinically by using the 'swallowing test'. At recruitment, upper-arm skin fold thickness (triceps and biceps) and mid-arm circumference were measured; and blood was drawn for serum albumin level. They were then followed up at 4 weeks where the above tests were repeated. A total of 22 patients completed the study (12 patients in the NG group and 10 patients in the PEG group). Serum albumin levels (p = 0.045) were significantly higher in the PEG as compared to the NG group at 4 weeks post-intervention. There were statistically significant improvements in serum albumin level (p = 0.024) in the PEG group; and statistically significant reductions in serum albumin level (p = 0.047) in the NG group 4 weeks after the intervention. However, there were no significant differences in anthropometric parameters between the two groups and no significant changes in these parameters for each group 4 weeks after the intervention. Treatment failure occurred in 5 out of 10 patients (50.0%) in the NG group, but none in PEG group (p = 0.056). PEG tube feeding Ls more effective than NG tube feeding in improving the nutritional status (in terms of the serum albumin level) of patients with dysphagic stroke. NG tube feeding, in fact, reduced the nutritional status (in terms of the serum albumin level) of the patients.

Original languageEnglish
Pages (from-to)59-66
Number of pages8
JournalMedical Journal of Malaysia
Volume61
Issue number1
Publication statusPublished - Mar 2006

Fingerprint

Gastrostomy
Enteral Nutrition
Stroke
Serum Albumin
Deglutition Disorders
Nutritional Status
Treatment Failure
Arm
Feeding Methods
Nutritional Support
Malaysia
Deglutition
Malnutrition
Nervous System
Randomized Controlled Trials
Prospective Studies
Safety
Skin

Keywords

  • Dysphagia
  • Nutritional status
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke. / Hamidon, Bin Basri; Abdullah, S. A.; Zawawi, M. F.; Sukumar, N.; Aminuddin, Amilia; Ali, Raymond Azman.

In: Medical Journal of Malaysia, Vol. 61, No. 1, 03.2006, p. 59-66.

Research output: Contribution to journalArticle

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