Ann Rehabil Med.  2014 Feb;38(1):6-12. 10.5535/arm.2014.38.1.6.

Associating Factors Regarding Nasogastric Tube Removal in Patients With Dysphagia After Stroke

• Lee JH
• Kim SB
• Lee KW
• Lee SJ
• Park JG
• Ri JW

• KMID: 2266534
• DOI: http://doi.org/10.5535/arm.2014.38.1.6

Abstract

OBJECTIVE
To demonstrate associating factors regarding nasogastric tube (NGT) removal in patients with dysphagia after stroke.
METHODS
This study is a retrospective medical chart review. Patients were divided into non-brain stem (NBS) and brain stem (BS) groups. A videofluoroscopic swallowing study was conducted until swallowing functions were recovered. Initial disease status was measured using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Risk factors related to stroke were evaluated. The penetration-aspiration scale (PAS) was used as the swallowing test. Functional status was measured by Mini-Mental Status Examination (MMSE) and Modified Barthel Index (MBI). Within each group, initial evaluations and their subsequent changes were compared according to the NGT removal status. Correlation between the NGT removal time and other initial factors were evaluated.
RESULTS
Ninety-nine patients were allocated to the NBS group and 39 to the BS group. In NBS, age, PAS, MMSE, and MBI were significantly different according to the NGT removal status. In BS, smoking and PAS were significantly different. In NBS, changes in PAS, MMSE, and MBI were significantly different according to the NGT removal status. In BS, only PAS change was significantly different. In NBS, initial NIHSS, mRS, MMSE, and MBI were correlated with removal time.
CONCLUSION
In stroke patients with NTG, younger age, better initial disease and functional status seems to remove NGT in NBS stroke. Therefore, when deciding to remove NGT, those three factors should be considered discreetly.

Keyword

Stroke; Dysphagia; Nasogastric tube; Fluoroscopy

MeSH Terms

Brain Stem
Deglutition
Deglutition Disorders*
Fluoroscopy
Humans
National Institutes of Health (U.S.)
Retrospective Studies
Risk Factors
Smoke
Smoking
Stroke*
Smoke

Figure

• 

  Fig. 1 In non-brain stem stroke patients, National Institutes of Health Stroke Scale (NIHSS, A) and modified Rankin Scale (mRS, B) showed a positive correlation, Mini-Mental Status Examination (MMSE, C) and Modified Barthel Index (MBI, D) showed a negative correlation with removal time.

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