title: Recommendation of Nasogastric Tube Removal in Acute Stroke Patients Based on Videofluoroscopic Swallow Study.
abstract: OBJECTIVE
  To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration.
  
  
  METHODS
  We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia. The penetration-aspiration scale (PAS) was used to assess VFSS findings. The patients were divided into thin-liquid aspiration group (group 1, n=104) and no thin-liquid aspiration group (group 2, n=95).
  
  
  RESULTS
  The feeding method was changed from NGT feeding to oral feeding with food thickener (group 1) and without food thickener (group 2). The PAS scores of thin and thick liquids were 6.46±0.65 and 1.92±0.73, respectively, in group 1 and 2.65±0.74 and 1.53±0.58, respectively, in group 2. Aspiration pneumonia developed in 1.9% of group 1 and 3.2% of group 2 (p=0.578), with no significant difference between the groups.
  
  
  CONCLUSIONS
  We concluded that removing the NGT and changing to oral feeding with a food thickener is a safe food modification for acute stroke patients with thin liquid aspiration. Therefore, we recommend that VFSS should be conducted promptly in acute stroke patients to avoid unnecessary prolonged NGT feeding.
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea.
authors.forename: Jong-Moon
authors.identifier: 0000-0002-9807-8783
authors.initials: JM
authors.lastname: Hwang
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea.
authors.forename: Youn-Soo
authors.identifier: 0000-0001-7105-4776
authors.initials: YS
authors.lastname: Cheong
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea.
authors.forename: Min-Gu
authors.identifier: 0000-0002-0680-9607
authors.initials: MG
authors.lastname: Kang
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Seong Min
authors.identifier: 0000-0002-2174-8742
authors.initials: SM
authors.lastname: Chun
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Yu-Sun
authors.identifier: 0000-0003-0373-0538
authors.initials: YS
authors.lastname: Min
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea.
authors.forename: Yang-Soo
authors.identifier: 0000-0002-8855-1231
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea.; Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Tae-Du
authors.identifier: 0000-0002-1636-8665
authors.initials: TD
authors.lastname: Jung
keywords: Aspiration pneumonia; Dysphagia; Food thickener; Nasogastric tube; Stroke