Predictors of nasogastric tube removal in patients with stroke and dysphagia.
Kun-Chang Lee, Chien-Ting Liu, I-Shiang Tzeng and 1 others
PMID 33927175WHAT IT FOUND
A four-item model using admission Barthel score, lip closure, ability to answer simple questions, and pre-stroke independence predicted nasogastric tube removal.
A score above the cutoff had 85.45% sensitivity and 73.44% positive predictive value for returning to oral feeding.
Key findings
01Admission Barthel index, lip closing status, ability to answer simple questions, and functional independence before stroke were significantly associated with nasogastric tube removal in univariate analysis.
02The multivariate logistic model achieved an area under the curve of 0.8204, with the optimal cutoff showing 85.45% sensitivity and 73.85% specificity.
03The positive predicted value for return to oral feeding using this model was 73.44%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was retrospective, so factors like patient appetite, nutritional status, and family support could not be assessed. There was no follow-up after discharge, so long-term swallowing outcomes are unknown. The model was derived from a specific rehabilitation ward population, limiting generalizability to acute or other settings.
Declared interests
The authors declared no financial or other support from organizations with an interest in the work.
The easy way to misread this
Do not assume a high positive predicted value means the treatment works. The 73.44% figure reflects the probability of tube removal based on baseline characteristics in this specific sample, not a guarantee of individual success or a validation of the rehabilitation protocol itself.