Race Differences in Gastrostomy Tube Placement After Stroke in Majority-White, Minority-Serving, and Racially Integrated US Hospitals.

The study used administrative claims data, so it could not show why a PEG tube was placed. It did not record patient preferences, provider decisions, or physician race, so it cannot identify the source of the differences. It lacked speech-language pathology and objective swallow testing data, so differences in access to swallow evaluation were not examined. It excluded transferred patients and admissions with a length of stay under 3 days, so it may not apply to all stroke hospitalizations. It relied on coded diagnoses and procedures and self-reported race, so miscoding or inaccurate race data is possible. It adjusted for comorbidities and complications but did not have detailed clinical stroke severity data. It cannot show that minority-serving hospitals cause higher PEG use.

The article metadata lists NIH extramural research support. The authors reported no other conflicts of interest, and Dr. Gottesman is an Associate Editor for Neurology.

Do not read this as proof that ethnic/racial minority patients choose PEG tubes more often. The study did not record patient preferences, and white patients had higher PEG odds in hospitals serving more minority patients.