Percutaneous endoscopic gastrostomy after acute stroke: complications and outcome.
OBJECTIVE
To review the complications and outcome of percutaneous endoscopic gastrostomy placement (PEG) in 74 patients with acute stroke.


METHODS
Medical record review and follow-up of patients with acute stroke admitted to a referral center.


RESULTS
There were no immediate procedure-related complications. Late complications included aspiration pneumonia (11%), PEG occlusion and replacement (6%), accidental PEG removal (6%), wound infection (3%) and fatal gastrointestinal bleeding in 1 patient. In 18 patients (28%), PEG could be subsequently removed due to improvement in swallowing.


CONCLUSIONS
PEG provides an effective alternative method of enteral feeding, but its impact on outcome remains uncertain. Late complications occurred in one third of the patients, but were seldom life threatening. Removal of the gastrostomy tube and resumption of oral feeding was possible in more than a quarter of the patients. All our patients who received PEG placement after acute stroke remained severely disabled; one third of the patients died from systemic complications of their stroke.
Wijdicks
E F
EF
Department of Neurology, Critical Care Neurology, Metabolism and Nutrition and Internal Medicine, Mayo Clinic and Mayo Medical Center, Saint Marys Hospital, Rochester, Minn. 55905, USA. wijde@mayo.edu
McMahon
M M
MM
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000401:mortality / Q000601:surgery*; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome