Gastrostomy in Hospitalized Patients with Acute Stroke: “NöroTek” Turkey Point Prevalence Study Subgroup Analysis

OpenAlex İngilizce

Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods:NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day).A total of 972 hospitalized neurovascular patients [female: 53%, age: 69±14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study.Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE.Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)]and hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)].PEG was found to be a significant negative indicator of favorable (modified Rankin's scale score 0-2) functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)]but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)].Nutritional and swallowing assessments were performed in approximately two-thirds of patients.Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days.Tube feeding was performed in 39% of the patients.In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later.Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey.In terms of being economical and accurate it makes sense to use the point prevalence method.