Bing Chen, MD1, Omar Mahmoud, MD1, Priya K. Simoes, MD2; 1Mount Sinai Morningside and West, New York, NY; 2Mount Sinai St. Luke's and Mount Sinai Roosevelt, New York, NY
Introduction: Percutaneous endoscopic gastrostomy (PEG) is a frequently performed procedure in patients with stroke. This study aimed to investigate the differences in in-hospital outcomes for stroke patients compared with non-stroke patients undergoing PEG. Methods: In this retrospective study, the 2016 National Inpatient Sample database was analyzed by using ICD-10 Code for hospitalizations with a procedure code of PEG. Those patients were further divided into the stroke or non-stroke group based on whether they had a primary or secondary diagnosis as ischemic or hemorrhage stroke. Patients who were younger than 18 were excluded from this analysis. The primary outcome of interest was in-hospital all-cause mortality. The secondary outcomes of interest were the rate of aspiration pneumonia, length of stay, and total cost of the hospital admission. Multivariate regression was used to adjust for age, gender, race, incomes, insurance, hospital characteristics, and comorbidities. STATA 14 (College Station, TX) was used for analysis. Results: A total of 27,500 patients with stroke underwent PEG in 2016, which made up 19.4% of all PEGs performed. Compared with patients without stroke, patients in the stroke group were older (69.1 vs 67.1 years, p< 0.001), more likely to be female (48.0% vs 42.9%, p< 0.001), and had a higher Charlson Comorbidity Index (4.20 vs 3.01, p< 0.001). Compared with the non-stroke group, the in-hospital all-cause mortality was not significantly different in stroke group (6.52% vs 6.74%) with an adjusted odds ratio (OR) of 0.95 [95%CI (0.83-1.08), p=0.416]. However, stroke patients had a higher rate of aspiration pneumonia (25.64% vs 20.99%, p< 0.001), a longer length of stay (21.6 days vs 19.8 days, p< 0.001), and higher total cost of hospital admission ($61745 vs $ 53972, p< 0.001). In the subgroup analysis of stroke patients undergoing PEG, Hispanic ethnicity [adjusted odds ratio: 1.65, 95%CI: 1.14-2.38, p< 0.01] and coexisting aspiration pneumonia [adjusted odds ratio: 1.53, 95% (1.21-1.94), p< 0.001] were associated with higher mortality. Discussion: Among patients undergoing PEG, stroke patients did not have a significantly different in-hospital all-cause mortality compared to non-stroke patients. However, they had a higher rate of aspiration pneumonia, a longer length of stay, and higher total cost of hospital admission.
Table 1: Basic characteristics of stroke vs. non-stroke patients undergoing PEG
Table 2: In-hospital outcomes of stroke vs. non-stroke patients undergoing PEG
Disclosures: Bing Chen indicated no relevant financial relationships. Omar Mahmoud indicated no relevant financial relationships. Priya Simoes indicated no relevant financial relationships.