Pre-Stroke Frailty and Outcomes following Percutaneous Endoscopic Gastrostomy Tube Insertion

Frailty is common in stroke, where it exerts disease- and treatment-modifying effects. However, there has been little work evaluating how frailty influences outcomes after percutaneous endoscopic gastrostomy (PEG) tube insertion. This study investigates the relationship between pre-stroke frailty an...

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Bibliographic Details
Published in:Healthcare (Basel) 2024-08, Vol.12 (16), p.1557
Main Authors: Gupta, Karan, Williams, Eleanor, Warburton, Elizabeth A, Evans, Nicholas Richard
Format: Article
Language:English
Subjects:
Brief Report
Care and treatment
Clinical outcomes
Decision-making
discharge destination
Dysphagia
Electronic health records
Endoscopy
Enteral nutrition
Frailty
Health aspects
Ischemia
Medical prognosis
Medical records
Mortality
Multidisciplinary teams
Nursing homes
Ostomy
Palliative care
Patient outcomes
Percutaneous endoscopic gastrostomy
Pneumonia
post-stroke dysphagia
Prognosis
Rehabilitation
Statistical analysis
Stroke
Stroke (Disease)
Stroke patients
Swallowing
United Kingdom
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Summary:Frailty is common in stroke, where it exerts disease- and treatment-modifying effects. However, there has been little work evaluating how frailty influences outcomes after percutaneous endoscopic gastrostomy (PEG) tube insertion. This study investigates the relationship between pre-stroke frailty and one-year mortality following PEG insertion. A pre-stroke frailty index (FI) was calculated for individuals with post-stroke dysphagia who underwent PEG insertion between March 2019 and February 2021. Mortality was recorded at one year, as well as instances of post-PEG pneumonia and discharge destination. Twenty-nine individuals underwent PEG insertion, eleven (37.9%) of whom died in the subsequent year. The mean (SD) FI for those who survived was 0.10 (0.09), compared to 0.27 (0.19) for those who died ( = 0.02). This remained significant after adjustment for age and sex, with each 0.1 increase in the FI independently associated with an increased odds of one-year mortality (aOR 1.39, 95% CI 1.17-1.67). There was no association between frailty and post-PEG pneumonia (0.12 (0.21) in those who aspirated versus 0.11 (0.18) in those who did not, = 0.75). Pre-stroke frailty is associated with increased one-year mortality after PEG, a finding that may help inform shared clinical decision-making in complex decisions regarding PEG feeding.
ISSN:2227-9032
2227-9032
DOI:10.3390/healthcare12161557