title: Predictors of recovery of functional swallow after gastrostomy tube placement for Dysphagia in stroke patients after inpatient rehabilitation: a pilot study.
abstract: OBJECTIVE
  To determine predictors of early recovery of functional swallow in patients who had gastrostomy (percutaneous endoscopic gastrostomy [PEG]) placement for dysphagia and were discharged to inpatient rehabilitation (IPR) after stroke.
  
  
  METHODS
  A retrospective study of prospectively identified patients with acute ischemic and hemorrhagic stroke from July 2008 to August 2012 was conducted. Patients who had PEG during stroke admission and were discharged to IPR, were studied. We compared demographics, stroke characteristics, severity of dysphagia, stroke admission events and medications in patients who remained PEG-dependent after IPR with those who recovered functional swallow.
  
  
  RESULTS
  Patients who remained PEG dependent were significantly older (73 vs. 54 years, p=0.009). Recovery of swallow was more frequent for hemorrhagic stroke patients (80% vs. 47%, p=0.079). Age, adjusting for side of stroke (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.82-0.98; p=0.016) and left-sided strokes, adjusting for age (OR, 15.15; 95% CI, 1.32-173.34; p=0.028) were significant predictors of swallow recovery. Patients who recovered swallowing by discharge from IPR were more likely to be discharged home compared to those who remained PEG-dependent (90% vs. 42%, p=0.009).
  
  
  CONCLUSIONS
  Younger age and left-sided stroke may be predictive factors of early recovery of functional swallow in patients who received PEG. Prospective validation is important as avoidance of unnecessary procedures could reduce morbidity and healthcare costs.
authors.affiliation: Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Crisan
authors.affiliation: Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Shaban
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. ; Department of Neurology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
authors.forename: Amelia
authors.initials: A
authors.lastname: Boehme
authors.affiliation: Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Perry
authors.initials: P
authors.lastname: Dubin
authors.affiliation: Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Jenifer
authors.initials: J
authors.lastname: Juengling
authors.affiliation: Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Schluter
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. ; Department of Neurology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA. ; Health Services and Outcomes Research, Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, Birmingham, AL, USA. ; Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC), University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Albright
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: T Mark
authors.initials: TM
authors.lastname: Beasley
authors.affiliation: Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA. ; Stroke Program, Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Martin-Schild
keywords: Acute ischemic stroke; Dysphagia; Gastrostomy; Rehabilitation