• Christa O'Hana V San Luis, Ilene Staff, Martin D Ollenschleger, Gilbert J Fortunato, and Louise D McCullough.
• Department of Neurology Hartford Hospital, Hartford, CT, USA Department of Neurology and Neurosciences, The University of Connecticut Health Center, Hartford, CT, USA.
• NeuroRehabilitation. 2013 Jan 1;33(2):201-8.

BackgroundProlonged dysphagia after middle cerebral artery (MCA) territory strokes may require percutaneous endoscopic gastrostomy (PEG) tube feeding.ObjectiveWe examined the predictors of PEG placement among patients with MCA stroke. It was hypothesized that stroke laterality was a predictor.MethodsA retrospective cohort study of existing data from Hartford Hospital Stroke Database was done. A total of 157 patients with acute ischemic MCA stroke were included. Patients were divided into the "PEG" group (n = 24) and "no PEG" group (n = 133). Existing demographic, clinical and swallowing data were compared between the 2 groups.ResultsDemographic data were similar between the groups. The "PEG" group had a higher admission National Institute of Health Stroke Scale (NIHSS) score, higher proportion of patients who had thrombolytic administration, in- hospital aspiration pneumonia and inability to be assessed on first swallow evaluation. Multivariate analysis revealed that all, except thrombolytic administration may predict PEG placement.ConclusionAdmission NIHSS score, in-hospital aspiration pneumonia and inability to undergo first swallow evaluation may predict PEG placement in patients with acute MCA stroke. Stroke laterality was not associated. This knowledge facilitates early identification of patients that may require PEG tube placement for early nutrition provision and discharge to rehabilitation.

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