A comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in prolonged dysphagic stroke patients

Abstract

Objective To evaluate the effectiveness and the safety of percutaneous endoscopic gastrostomy (PEG) as compared with a nasogastric (NG) tube for adults with prolonged neurological dysphagia after stroke. Design A prospective case-controlled study. Patients and methods This study included 90 patients with severe neurogenic dysphagia categorized into two groups: those on PEG feeding and those on NG feeding because they refused PEG. A comparison of both groups was assessed by several methods. The primary outcome measures were death and aspiration pneumonia during 3 months' observation and the 2ry outcome measures were changes in the nutritional state during this period and patient and family satisfaction. Results Weight gain was significantly higher among patients in the NG group. The incidence of aspiration pneumonia was significantly higher among patients in the NG group (14) compared with seven patients in PEG. There were four (8.3%) deaths in the PEG group compared with eight (18.2%) in the NG group. Conclusion This study has demonstrated that PEG feeding in long-term dysphagic patients with stroke is associated with a significant reduction in the incidence of aspiration pneumonia with reduced mortality at 3 months. PEG is more acceptable and less irritating to patients and is superior in the delivery of feed and maintaining the nutritional status and improves the long-term quality of life.