Türk Nöroloji Dergisi (Sep 2022)

Gastrostomy in Hospitalized Patients with Acute Stroke: 'NöroTek' Turkey Point Prevalence Study Subgroup Analysis

  • Mehmet Akif Topçuoğlu,
  • Atilla Özcan Özdemir,
  • Özlem Aykaç,
  • Aysel Milanoğlu,
  • Mustafa Gökçe,
  • Songül Bavli,
  • Murat Çabalar,
  • Vildan Yayla,
  • Hacı Ali Erdoğan,
  • Ayça Özkul,
  • Aygül Güneş,
  • Bahar Değirmenci,
  • Ufuk Aluçlu,
  • Hasan Hüseyin Kozak,
  • Levent Güngör,
  • Mücahid Erdoğan,
  • Zeynep Özdemir Acar,
  • Utku Cenikli,
  • Yüksel Kablan,
  • Arda Yılmaz,
  • Hamit Genç,
  • Bijen Nazliel,
  • Hale Batur Çağlayan,
  • Elif Sarıönder Gencer,
  • Halil Ay,
  • Hayri Demirbaş,
  • Özlem Akdoğan,
  • Ufuk Emre,
  • Özlem Kayım Yıldız,
  • Aslı Bolayır,
  • Turgay Demir,
  • Zeynep Tanrıverdi,
  • Ülgen Yalaz Tekan,
  • Çetin Kürşad Akpınar,
  • Esra Özkan,
  • Faik İlik,
  • Hadiye Şirin,
  • Ayşe Güler,
  • Halil Önder,
  • Hesna Bektaş,
  • Levent Öcek,
  • Mustafa Bakar,
  • Nedim Ongun,
  • Yakup Krespi,
  • Canan Togay Işıkay,
  • Eda Aslanbaba,
  • Mine Sorgun,
  • Erdem Gürkaş,
  • Hasan Hüseyin Karadereli,
  • İpek Midi,
  • İrem İlgezdi,
  • Adnan Burak Bilgiç,
  • Şener Akyol,
  • M. Tuncay Epçeliden,
  • Murat Mert Atmaca,
  • Oğuzhan Kurşun,
  • Onur Keskin,
  • Pınar Bekdik Şirinocak,
  • Recep Baydemir,
  • Merve Akçakoyunlu,
  • Şerefnur Öztürk,
  • Tuğba Özel,
  • Ali Ünal,
  • Babür Dora,
  • Vedat Ali Yürekli,
  • Zülfikar Arlıer,
  • Alper Eren,
  • Ayşe Yılmaz,
  • Ayşin Kısabay,
  • Bilgehan Acar,
  • Birgül Baştan,
  • Zeynep Acar,
  • Buket Niflioğlu,
  • Bülent Güven,
  • Dilaver Kaya,
  • Nazire Afşar,
  • Duran Yazıcı,
  • Emrah Aytaç,
  • Erdem Yaka,
  • Eren Toplutaş,
  • Eylem Değirmenci,
  • Fatma Birsen İnce,
  • Gülseren Büyükşerbetçi,
  • İsa Aydın,
  • Mustafa Çetiner,
  • Mustafa Şen,
  • Nilda Turgut,
  • Nilüfer Kale,
  • Eda Çoban,
  • Nilüfer Yeşilot,
  • Esme Ekizoğlu,
  • Özgü Kizek,
  • Özlem Birgili,
  • Recep Yevgi,
  • Refik Kunt,
  • Semih Giray,
  • Sinem Yazıcı Akkaş,
  • Songül Şenadım,
  • Tahir Yoldaş,
  • Talip Asil,
  • Taşkın Duman,
  • Tuğrul Atasoy,
  • Bilge Piri Çınar,
  • Tülin Demir,
  • Ufuk Can,
  • Yaprak Özüm Ünsal,
  • Neslihan Eşkut,
  • Yıldız Aslan,
  • Demet Funda Baş,
  • Ufuk Şener,
  • Zahide Yılmaz,
  • Zehra Bozdoğan,
  • Zekeriya Alioğlu,
  • Ethem Murat Arsava

DOI
https://doi.org/10.4274/tnd.2022.52460
Journal volume & issue
Vol. 28, no. 3
pp. 134 – 141

Abstract

Read online

Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69+-14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin's scale score 0-2) functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method.

Keywords