Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 16, Number 6, December 2023, pages 281-288

Timing and Outcomes of Percutaneous Endoscopic Gastrostomy After Ischemic Stroke

Figure 2. Distribution of median time from stroke to PEG in early vs. late PEG. PEG: percutaneous endoscopic gastrostomy.

**Table 1.** Patient Demographics and Comorbidities in the Early and Late PEG Groups
Characteristics	n	All PEG	Early PEG (n = 98)	Late PEG (n = 63)	P-value
CCI: Charlson Comorbidity Index; IQR: interquartile range; PEG: percutaneous endoscopic gastrostomy; SD: standard deviaton; NIHSS: National Institute of Health Stroke Scale.
Age, years, median (IQR)	161	66 (63 - 75)	67 (56 - 77)	65 (50 - 72)	0.055
Age, years, N (%)					0.464
< 65		74 (45.9)	43 (43.9)	31 (49.2)
65 - 75		51 (31.7)	29 (29.6)	22 (34.9)
75 - 85		28 (17.4)	20 (20.8)	8 (12.7)
> 85		8 (4.9)	6 (6.1 )	2 (3.17)
Gender, male, N (%)		99 (61.5)	56 (57.1)	43 (68.2)	0.157
Race/ethnicity, N (%)					0.871
Non-Hispanic White		89 (55.3)	52 (53.1)	37 (58.7)
Hispanic		37 (22.9)	23 (23.5)	14 (22.2)
Black		16 (9.9)	11 (11.2)	5 (7.9)
Other		19 (11.8)	12 (12.2)	7 (11.1)
Comorbidities, N (%)	161				0.351
CCI score: 1 - 2		34 (21.1)	23 (23.5)	11 (17.5)
CCI score: 3 - 4		71 (44.1)	45 (45.9)	26 (41.3)
CCI score: > 5		56 (34.8)	30 (30.6)	26 (41.3)
Atrial fibrillation, N (%)		62 (38.5)	38 (38.8)	24 (38.1)	0.931
Mechanical ventilation, N (%)		83 (51.5)	46 (46.9)	37 (58.7)	0.144
Tracheostomy, N (%)		38 (23.7)	25 (25.77)	13 (20.63)	0.456
Hospital length of stay, mean (SD)		17.4 (12.9)	15.8 (1.4)	20.11 (14.8)	0.029
Stroke characteristics
NIHSS, median (IQR)	120	16.5 (7 - 23.5)	16 (7 - 24)	17 (7 - 23)	0.968

Table 1. Patient Demographics and Comorbidities in the Early and Late PEG Groups

Characteristics

All PEG

Early PEG (n = 98)

Late PEG (n = 63)

P-value

CCI: Charlson Comorbidity Index; IQR: interquartile range; PEG: percutaneous endoscopic gastrostomy; SD: standard deviaton; NIHSS: National Institute of Health Stroke Scale.

Age, years, median (IQR)

161

66 (63 - 75)

67 (56 - 77)

65 (50 - 72)

0.055

Age, years, N (%)

0.464

< 65

74 (45.9)

43 (43.9)

31 (49.2)

65 - 75

51 (31.7)

29 (29.6)

22 (34.9)

75 - 85

28 (17.4)

20 (20.8)

8 (12.7)

> 85

8 (4.9)

6 (6.1 )

2 (3.17)

Gender, male, N (%)

99 (61.5)

56 (57.1)

43 (68.2)

0.157

Race/ethnicity, N (%)

0.871

Non-Hispanic White

89 (55.3)

52 (53.1)

37 (58.7)

Hispanic

37 (22.9)

23 (23.5)

14 (22.2)

Black

16 (9.9)

11 (11.2)

5 (7.9)

Other

19 (11.8)

12 (12.2)

7 (11.1)

Comorbidities, N (%)

161

0.351

CCI score: 1 - 2

34 (21.1)

23 (23.5)

11 (17.5)

CCI score: 3 - 4

71 (44.1)

45 (45.9)

26 (41.3)

CCI score: > 5

56 (34.8)

30 (30.6)

26 (41.3)

Atrial fibrillation, N (%)

62 (38.5)

38 (38.8)

24 (38.1)

0.931

Mechanical ventilation, N (%)

83 (51.5)

46 (46.9)

37 (58.7)

0.144

Tracheostomy, N (%)

38 (23.7)

25 (25.77)

13 (20.63)

0.456

Hospital length of stay, mean (SD)

17.4 (12.9)

15.8 (1.4)

20.11 (14.8)

0.029

Stroke characteristics

NIHSS, median (IQR)

120

16.5 (7 - 23.5)

16 (7 - 24)

17 (7 - 23)

0.968

**Table 2.** Primary and Secondary Outcomes in the Early and Late PEG Groups
Characteristics	Early PEG (n = 98)	Late PEG (n = 63)	P-value
PEG: percutaneous endoscopic gastrostomy.
30-day mortality	7 (7.14)	4 (6.35)	0.558
PEG-related complications, N (%)	9 (9.18)	2 (3.17)	0.204
PEG removal and functional swallow recovery
PEG removed, N (%)	20 (20.41)	23 (36.51)	0.024
PEG present, partial swallow recovery, N (%)	10 (10.20)	8 (12.7)	0.624
PEG dependent, N (%)	46 (46.94)	26 (41.27)	0.48

Table 2. Primary and Secondary Outcomes in the Early and Late PEG Groups

Characteristics

Early PEG (n = 98)

Late PEG (n = 63)

P-value

PEG: percutaneous endoscopic gastrostomy.

30-day mortality

7 (7.14)

4 (6.35)

0.558

PEG-related complications, N (%)

9 (9.18)

2 (3.17)

0.204

PEG removal and functional swallow recovery

PEG removed, N (%)

20 (20.41)

23 (36.51)

0.024

PEG present, partial swallow recovery, N (%)

10 (10.20)

8 (12.7)

0.624

PEG dependent, N (%)

46 (46.94)

26 (41.27)

0.48

**Table 3.** Univariable and Multivariable Logistic Regression Model for PEG Removal and Swallowing Recovery
Patient characteristics	Univariable	Multivariable
Dash (-) indicates that the variable was included in the multivariable model but was not statistically significant. CCI: Charles Comorbidity Index; CI: confidence interval; NIHSS: National Institute of Health Stroke Scale; PEG: percutaneous endoscopic gastrostomy.
Age, years	0.97	0.95 - 0.99	0.08	-	-	-
Male gender (compared to females)	0.70	0.34 - 1.47	0.35	-	-	-
Late PEG (compared to early PEG)	2.24	1.10 - 4.56	0.03	3.27	1.22 - 8.74	0.02
Hispanic race (compared to white)	0.56	0.15 - 2.12	0.39	-	-	-
Black race (compared to white)	0.57	0.22 - 1.45	0.2	-	-	-
Other race (compared to white)	1.41	0.50 - 3.99	0.51	-	-
NIHSS	0.95	0.91 - 0.99	0.04	0.95	0.89 - 0.99	0.045
CCI score: 3 - 4 (compared to 1 - 2)	0.82	0.35 - 1.95	0.66	-	-	-
CCI score > 5 (compared to 1 - 2)	0.35	0.13 - 0.95	0.04	-	-	-
Palliative care	0.22	0.05 - 0.99	0.48

Table 3. Univariable and Multivariable Logistic Regression Model for PEG Removal and Swallowing Recovery

Patient characteristics

Univariable

Multivariable

Odds ratio

95% CI

P-value

Odds ratio

95% CI

P-value

Dash (-) indicates that the variable was included in the multivariable model but was not statistically significant. CCI: Charles Comorbidity Index; CI: confidence interval; NIHSS: National Institute of Health Stroke Scale; PEG: percutaneous endoscopic gastrostomy.

Age, years

0.97

0.95 - 0.99

0.08

Male gender (compared to females)

0.70

0.34 - 1.47

0.35

Late PEG (compared to early PEG)

2.24

1.10 - 4.56

0.03

3.27

1.22 - 8.74

0.02

Hispanic race (compared to white)

0.56

0.15 - 2.12

0.39

Black race (compared to white)

0.57

0.22 - 1.45

0.2

Other race (compared to white)

1.41

0.50 - 3.99

0.51

NIHSS

0.95

0.91 - 0.99

0.04

0.95

0.89 - 0.99

0.045

CCI score: 3 - 4 (compared to 1 - 2)

0.82

0.35 - 1.95

0.66

CCI score > 5 (compared to 1 - 2)

0.35

0.13 - 0.95

0.04

Palliative care

0.22

0.05 - 0.99

0.48

**Table 4.** Univariable and Multivariable Logistic Regression Model Assessing the Association Between Early PEG and Patient Factors
Patient characteristics	Univariable	Multivariable
Dash (-) indicates that the variable was included in the multivariable model but was not statistically significant. CCI: Charles Comorbidity Index; CI: confidence interval; NIHSS: National Institute of Health Stroke Scale; PEG: percutaneous endoscopic gastrostomy; SNF: skilled nursing facility.
Age, years	1.08	0.99 - 1.04	0.07	-	-	-
Male gender (compared to females)	1.6	0.83 - 3.13	0.16	-	-	-
Race	1.07	0.81 - 1.43	0.61
CCI score	0.73	0.47 - 1.13	0.16	-	-	-
NIHSS	0.99	0.96 - 1.03	0.92	0.95	0.90 - 0.99	0.02
Speech therapy evaluation	0.69	0.31 - 153	0.36
Tracheostomy status	1.33	0.62 - 2.85	0.46
Intubation status	0.62	0.33 - 1.18	0.16	-	-	-
All infection	0.54	0.28 - 1.01	0.06	0.32	0.14 - 0.73	0.007
Hospice (compared to home/acute rehabilitation)	1.89	0.42 - 8.6	0.41
SNF (compared to home/Acute rehabilitation facility)	2.69	1.37 - 5.28	0.004	3.4	1.48 - 7.8	0.004

Table 4. Univariable and Multivariable Logistic Regression Model Assessing the Association Between Early PEG and Patient Factors

Patient characteristics

Univariable

Multivariable

Odds ratio

95% CI

P-value

Odds ratio

95% CI

P-value

Age, years

1.08

0.99 - 1.04

0.07

Male gender (compared to females)

1.6

0.83 - 3.13

0.16

Race

1.07

0.81 - 1.43

0.61

CCI score

0.73

0.47 - 1.13

0.16

NIHSS

0.99

0.96 - 1.03

0.92

0.95

0.90 - 0.99

0.02

Speech therapy evaluation

0.69

0.31 - 153

0.36

Tracheostomy status

1.33

0.62 - 2.85

0.46

Intubation status

0.62

0.33 - 1.18

0.16

All infection

0.54

0.28 - 1.01

0.06

0.32

0.14 - 0.73

0.007

Hospice (compared to home/acute rehabilitation)

1.89

0.42 - 8.6

0.41

SNF (compared to home/Acute rehabilitation facility)

2.69

1.37 - 5.28

0.004

3.4

1.48 - 7.8

0.004