Therapy

Consider inserting percutaneous gastrostomy tubes (PEG) for patients with persistent dysphagia ^a unless they have ^c

• GI abnormalities 
• ascites or hepatomegaly 
• clotting disorders 

• Patients who receive PEG feeding compared with nasogastric tube feeding are less likely to die ^a , and are more likely to put on weight. ^a
• PEG feeding is less likely to fail than nasogastric tube feeding. There is no clear difference in the complication rate. ^a

Dysphagia: fewer patients die or fail treatment on PEG feeding than nasogastric tube feeding

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
stroke and dysphagia a	percutaneous gastrostomy tube feeding	nasogastric tube feeding	death at 6-12 weeks	61%	0.28 (0.09 to 0.89)	3 (2 to )
			treatment failures at 6-12 weeks	26%	0.10 (0.02 to 0.52)	4 (4 to 9)

Dysphagia: more patientsgain weight on PEG feeding than nasogastric tube feeding

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
stroke and persistent dysphagia for ≥ 8 days a	percutaneous gastrostomy tube feeding	nasogastric tube feeding	weight gain at 7 days	13%	-64% (-97% to -32%)	2 (1 to 3)