Percutaneous endoscopic gastrostomy versus nasogastric tube feeding in post-stroke dysphagia: a meta-analysis study.
Gamal Youssef, Rania M Abdou, Khaled Bamakhrama et al.
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In 30 seconds
This meta-analysis compared percutaneous endoscopic gastrostomy (PEG) with nasogastric tube (NGT) feeding in people with post-stroke dysphagia. It included 10 studies involving 1,416 participants and pooled outcomes using random-effects models. Compared with NGT, PEG was associated with lower pneumonia risk (RR 0.53; 95% CI 0.42-0.67; p < 0.001) and higher serum albumin (MD +4.56 g/L; 95% CI 1.25-7.87; p = 0.007). A lower pooled mortality risk was not confirmed in analyses restricted to randomised controlled trials.
Key findings
- PEG was associated with lower pneumonia risk than NGT (RR 0.53; 95% CI 0.42-0.67; p < 0.001).
- Serum albumin was higher with PEG (MD +4.56 g/L; 95% CI 1.25-7.87; p = 0.007).
- Pooled mortality was lower with PEG (RR 0.70; 95% CI 0.50-0.98; p = 0.039), but this was not significant in RCT-only sensitivity analysis.
- No significant differences were found in mid-arm circumference (p = 0.16) or length of stay (p = 0.34).
Why it matters
Feeding route may be relevant to pneumonia risk and nutritional status in post-stroke dysphagia. The findings suggest potential advantages of PEG for these outcomes, while the mortality result is less robust. Considering the balance of possible benefits, procedural risks, and individual factors is important when interpreting comparative feeding evidence.
What to keep in mind
The pooled mortality benefit was not significant in RCT-only sensitivity analysis, suggesting possible confounding. The authors call for further high-quality randomised controlled trials.