Objective
To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke.
Methods
This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients’ demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated.
Results
There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634–0.987) and PAS scores (OR=0.205; 95% CI, 0.059–0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively.
Conclusion
In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.

Citations

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  Yijing Li, Zhihua Xu, Xu Zhang, Dongfei Ma, Xiangfei Meng, Mengting Zhang, Jiao Sun
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  Jonathan Willman, Brandon Lucke-Wold
  World Journal of Gastrointestinal Pharmacology and Therapeutics.2023; 14(1): 1.     CrossRef
• Association between successful weaning from nasogastric tube feeding and thoracic muscle mass in patients with aspiration pneumonia
  Hyun Woo Lee, Dong Hyun Kim, Kwang Nam Jin, Hyo-Jin Lee, Jung-Kyu Lee, Tae Yeon Park, Deog Kyeom Kim, Eun Young Heo
  Medicine.2023; 102(30): e34298.     CrossRef
• Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease
  Giuseppe Cosentino, Massimiliano Todisco, Carla Giudice, Cristina Tassorelli, Enrico Alfonsi
  Current Opinion in Neurology.2022; 35(6): 741.     CrossRef