Effect of Percutaneous Endoscopic Gastrostomy Tube Placement on Confusion/Delirium in Stroke Patients with Dysphagia
Rakesh Shetty Rajalbandi1, Adnan Qureshi3, Navpreet Bains4, Syed Gillani5, Hamza Maqsood2
1Neurology, University of Missouri, 2University of Missouri, 3Dept of Neurology, 4University of Missouri, Columbia, 5Houston Methodist Hospital
Objective:
We identified the effect of placement of percutaneous endoscopic gastrostomy (PEG) tube on the confusion and delirium in stroke patients.
Background:
Enteric tubes are uncomfortable and restrict mobility in stroke patients with dysphagia often leading to agitation and confusion. Substitution of enteric tube with PEG tube may improve agitation and confusion.
Design/Methods:
We analyzed consecutive stroke patients admitted to our inpatient stroke service in past 24 months who received PEG tube. We compared the average confusion assessment method (CAM) scores (measured every 12 hrs) in the 24 hours pre- and post- PEG tube placement.
Results:
A total of 58 patients (67.4 ±15.2 years; 36men) were analyzed. PEG tube was placed after a mean period of 7(±11.47) days post admission. The average pre-procedure CAM score was 0.5345 (±0.9312) and post-procedure CAM score was 0.6724(±1.1104). There was no significant difference between pre- and post-procedure CAM score (Wilcoxon rank sum test, p=0.6592).
Conclusions:
We did not identify any significant differences in pre- and post-procedure CAM score in stroke patients with dysphagia undergoing PEG tube placement. However, our study population was predominantly consisting of patients with low CAM score and may not reflect those with severe confusion/delirium.