Clinical Outcomes and Patient Safety of Nasogastric Tube in Acute Stroke Patients.

The study was retrospective and from one institution, so the findings may not apply to other stroke units. Patients were identified from discharge summaries and handover notes, so some nasogastric tube cases may have been missed. The timing of tube insertion was not reliably documented, and the experience of the person inserting the tube was unknown. The complication count includes many different events, from tube malposition to use of restraints, so it does not show how severe each complication was. Family discussion before insertion and risk discussion were poorly documented, so consent quality cannot be judged. The mortality analysis is observational; it cannot prove that the tube, pneumonia, or repeated insertions caused death or prevented death. The decision tree analysis excluded patients with missing stroke severity scores.

The funding statement names Monash University. The supplied text does not include author conflict-of-interest declarations.

Do not read the high complication rate or the lower death rate among patients with multiple tube insertions as proof that nasogastric tubes cause death or that repeated insertions are protective. This was a retrospective audit without a comparison group, so it can show associations but not cause.