Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes

Table 1 Patient demographics

	All (N = 154)		PEG ≤ 7 d (N = 62, 40.26%)		PEG > 7 d (N = 92, 59.74%)		P value
	N	SD	N	SD	N	SD
Age	69.62	15.02	74.65	13.89	66.24	14.87	0.00051
Sex							0.0658
Female	78	50.65	37	59.68	41	44.57
Male	76	49.35	25	40.32	51	55.43
Any comorbidity	147	95.45	59	95.16	88	95.65	1.00002
Number of comorbidities							0.43393
0	7	4.55	3	4.84	4	4.35
1	26	16.88	12	19.35	14	15.22
2	37	24.03	13	20.97	24	26.09
3	41	26.62	17	27.42	24	26.09
4	26	16.88	12	19.35	14	15.22
5	8	5.19	4	6.45	4	4.35
6	5	3.25	0	0.00	5	5.43
7	3	1.95	1	1.61	2	2.17
8	0	0.00	0	0.00	0	0.00
9	1	0.65	0	0.00	1	1.09

¹Obtained by Student's t-test;

²Obtained by Fisher's exact test;

³Obtained by Poisson regression, PEG: Percutaneous endoscopic gastrostomy, Significant P values are in bold.

Table 2 Patient comorbidities

Types of comorbidities	All (N = 154)		PEG ≤ 7 d (N = 62, 40.26%)		PEG > 7 d (N = 92, 59.74%)		P value
	N	%	N	%	N	%
Acute respiratory distress syndrome	1	0.65	0	0.00	1	1.09	1.00001
Acute kidney injury	2	1.30	0	0.00	2	2.17	0.5158
Alcohol abuse	5	3.25	2	3.23	3	3.26	1.00001
Amyotrophic lateral sclerosis	1	0.65	0	0.00	1	1.09	1.00001
Anemia	4	2.60	2	3.23	2	2.17	1.00001
Aortic dissection	1	0.65	0	0.00	1	1.09	1.00001
Aortic stenosis	1	0.65	0	0.00	1	1.09	1.00001
Arrhythmias	7	4.55	4	6.45	3	3.26	0.44031
Atrial fibrillation	32	20.78	17	27.42	15	16.30	0.0955
Breast cancer	3	1.95	2	3.23	1	1.09	0.56521
Coronary artery disease	29	18.83	9	14.52	20	21.74	0.2609
Cirrhosis	1	0.65	1	1.61	0	0.00	0.40261
Chronic kidney disease	14	9.09	2	3.23	12	13.04	0.0377
Colon cancer	2	1.30	2	3.23	0	0.00	0.16051
Chronic obstructive pulmonary disease	9	5.84	1	1.61	8	8.70	0.08531
Dementia	15	9.74	5	8.06	10	10.87	0.5648
Diabetes mellitus	52	33.77	19	30.65	33	35.87	0.5014
Deep vein thrombosis	1	0.65	1	1.61	0	0.00	0.40261
Heart failure	24	15.58	11	17.74	13	14.13	0.5445
Hyperlipidemia	45	29.22	20	32.26	25	27.17	0.4963
Hypertension	121	78.57	45	72.58	76	82.61	0.1369
Lung cancer	1	0.65	0	0.00	1	1.09	1.00001
Nonalcoholic steatohepatitis	1	0.65	0	0.00	1	1.09	1.00001
Obstructive sleep apnea	3	1.95	1	1.61	2	2.17	1.00001
Peripheral artery disease	6	3.90	5	8.06	1	1.09	0.03911
Parkinson's disease	2	1.30	0	0.00	2	2.17	0.51581
Patent Foramen Ovale	1	0.65	1	1.61	0	0.00	0.40261
Prostate cancer	2	1.30	0	0.00	2	2.17	0.51581
Pulmonary hypertension	1	0.65	1	1.61	0	0.00	0.40261
Seizure disorder	4	2.60	2	3.23	2	2.17	1.00001
Stroke	38	24.68	14	22.58	24	26.09	0.62061
Substance abuse	1	0.65	0	0.00	1	1.09	1.00001
Thrombocytopenia	2	1.30	1	1.61	1	1.09	1.00001
Thyroid cancer	1	0.65	1	1.61	0	0.00	0.40261

¹Obtained by Fisher's Exact Test, PEG: Percutaneous endoscopic gastrostomy, Significant P values are in bold.

Table 3 Mortality and complications in percutaneous endoscopic gastrostomy tubes placed ≤ 7 d vs > 7 d post stroke

	Early PEG group (≤ 7 d)	Late PEG group (> 7 d)	Analysis value (P)
30-d mortality (Number of events)	3	5	1.001
Peri-procedural complications (number of events)	3	8	0.531
Post-procedural complications (number of events)	20	34	0.551
Hospital length of stay (d)	12.9	22.34	< 0.0012

¹Obtained by Fisher's exact test;

²Obtained by Student's t-test; PEG: Percutaneous endoscopic gastrostomy, Significant P values are in bold.

Table 4 Types of peri-procedural and post procedural complications

	Early PEG group	Late PEG group	Analysis value (P) Fisher’s exact
Peri procedural complication
Pulled PEG tube	0	1	1
Pulmonary edema	0	1	1
NSTEMI	0	1	1
Bleeding	0	4	0.15
Pneumonia	1	1	1
Evolving stroke/herniation	1	0	0.4
Post procedural complications
Aspiration	8	14	0.69
Pneumonia	10	16	0.84
Bleeding	2	2	1
Buried bumper	1	0	0.4
Cardiac arrest	2	1	0.57
Death	7	8	0.59
Ileus	0	1	1
Infection	5	4	0.49
Necrotizing pancreatitis	0	1	1
Pulled PEG tube	3	9	0.36
Pulmonary embolism	0	3	0.27
Respiratory failure	1	3	0.65
Seroma	1	0	0.4
Stroke	1	2	1

PEG: Percutaneous endoscopic gastrostomy; NSTEMI: Non-ST elevation myocardial infarction, Significant P values are in bold.

Table 5 Predictors of mortality: Multivariate logistic regression analysis

	Death in 30 d, OR [95%CI]	Death in 90 d, OR [95%CI]	Peri-procedural complication, OR [95%CI]	Post-procedural complications, OR [95%CI]
Protein calorie malnutrition (albumin ≤ 3.2)	0.757 [0.179-3.21]	0.854 [0.289-2.527]	1.31 [0.37-4.7]	1.07 [0.54-2.11]
Documented SIRS criteria or infection pre-procedure	0.524 [0.06-4.52]	0.56 [0.12-2.67]	1.55 [0.38-6.28]	1.92 [0.85-4.35]
Presence of cardiovascular risk equivalent independent of this stroke	0.24 [0.05-1.24]	0.35 [0.11-1.09]	0.65 [0.19-2.23]	1.63 [0.82-3.24]

SIRS: Systemic inflammatory response syndrome; OR: Odds ratio; PEG: Percutaneous endoscopic gastrostomy, Significant P values are in bold.