Abstract WP132: National Trends In Utilization And Outcomes Of Acute Ischemic Stroke And Intracerebral Hemorrhage Patients Undergoing Gastrostomy Tube Placement

Background and Purpose: Persistent dysphagia requiring gastrostomy tube placement continues to be a major issue for stroke patients. We performed analysis to evaluate trends in utilization of gastrostomy tube placement and associated rates of death among acute ischemic stroke (IS) and intracerebral hemorrhage (ICH) patients over a 10-year period. Methods: We obtained data for patients admitted to hospitals in United States from 2009 to 2018 with a primary diagnosis of IS or ICH using a large national database. We determined rate and pattern of utilization and associated in-hospital outcomes of gastrostomy tube placement among IS and ICH patients. Results: A total of 50551 (7.05%) and 136922 (2.45%) patients underwent gastrostomy tube placement among the 716777and 5567538patients admitted with ICH and IS, respectively. There was a 3.2-fold decrease in patients who gastrostomy tube placement among patients with IS (2.3% in 2009 vs 0.7% in 2018; P<0.001), and by a 1.5-fold decrease for those with ICH (7.8% in 2009 vs 5.3% in 2018; P<0.001). The rates of in-hospital mortality among patients undergoing gastrostomy tube placement remained unchanged throughout the 10 years for patients with IS (5.2% in 2009 vs 4.9% in 2018; p = 0.54) but decreased by fold for those with ICH (7.58% in 2009 vs 2.7% in 2010; p = 0.01). The length of hospitalization remained significantly higher in patients undergoing gastrostomy tube placement compared with those who did not for both patients with IS (16.2 ±15.7versus 3.6±4.3, p<.0001) and those with ICH (24.4±22.1 versus 6.0±7.5, p<.0001). The cost of hospitalization remained significantly higher in patients undergoing gastrostomy tube placement compared with those who did not for both patients with IS ($140563± 172413 versus $ 37950.2± 45101.6, p<.0001) and those with ICH ($254519± 251973 versus $ 62133.3± 90833.9, p<.0001). Conclusions: Between 2009 and 2018, there has been a significant reduction in the proportion of IS and ICH patients who underwent gastrostomy tube placement. However, the length and cost of hospitalization remained significantly higher among patients who underwent gastrostomy tube placement.