摘要
Abstract
Objective:To investigate factors influencing survival status in stroke patients with severe dysphagia fol-lowing percutaneous endoscopic gastrostomy(PEG),thereby providing evidence for optimizing clinical manage-ment.Methods:This single-center retrospective cohort study was conducted at Beijing Bo'ai Hospital,China Reha-bilitation Research Center.The study included 122 patients who underwent initial PEG tube placement between Oc-tober 2010 and October 2022.Demographic characteristics,stroke type,length of hospitalization,PEG tube reten-tion status,and survival status were collected.Univariate and multivariate logistic regression analyses were per-formed to evaluate independent predictors of mortality risk.Results:The median follow-up period was 38.5 months(IQR 19.0-57.5).During the follow-up period,43 patients(35.2％)died and 79(64.8％)survived.Univariate analysis showed that the deceased patient group was significantly older(P＜0.001)and had a significantly shorter median hospital stay(P=0.003)than the surviving group.Complications such as malnutrition,granulation tissue formation,reflux,and pneumonia were significantly more prevalent in deceased patients(all P＜0.05).Multivari-ate logistic regression analysis revealed that ischemic stroke(compared to hemorrhagic stroke)(OR=0.16,95％CI:0.05-0.56,P=0.004)and longer hospitalization(OR=0.98,95％CI:0.96-0.99,P=0.013)were inde-pendent protective factors for survival.Advanced age was an independent risk factor for mortality(OR=1.08,95％CI:1.03-1.14,P=0.001).PEG tube removal was associated with significantly higher survival rates than contin-ued retention(OR=175.04,95％CI:20.03-1529.38,P＜0.001).Conclusion:Stroke type,length of hospitaliza-tion,and age are important factors affecting survival in post-PEG patients.Recovery of swallowing function,lead-ing to PEG tube removal,is strongly associated with improved long-term survival,highlighting functional recovery as a key determinant of prognosis.关键词
经皮内镜下胃造瘘术/脑卒中/吞咽障碍/生存分析Key words
percutaneous endoscopic gastrostomy/stroke/dysphagia/survival analysis分类
医药卫生
