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    Gastrostomy in hospitalized patients with acute stroke: "NöroTek" Turkey point prevalence study subgroup analysis
    (Turkish Neurological Society, 2022) Topçuoğlu, Mehmet Akif; Özdemir, Atilla Özcan; Aykaç, Özlem; Milanoğlu, Aysel; Gökçe, Mustafa; Bavli, Songül; Çabalar, Murat; Yayla, Vildan; Erdoğan, Haci Ali; Özkul, Ayça; Güneş, Aygül; Değirmenci, Bahar; Aluçlu, Ufuk; Kozak, Hasan Hüseyin; Güngör, Levent; Erdoğan, Mücahid; Özdemir Acar, Zeynep; Cenikli, Utku; Kablan, Yüksel; Yılmaz, Arda; Genç, Hamit; Nazliel, Bijen; Çaglayan, Hale Batur; Sarıönder Gencer, Elif; Ay, Halil; Demirbaş, Hayri; Akdoğan, Özlem; Emre, Ufuk; Kayım Yıldız, Özlem; Bolayır, Aslı; Demir, Turgay; Tanrıverdi, Zeynep; Tekan, Ulgen Yalaz; Akpınar, Çetin Kürşad; Özkan, Esra; Ilık, Faik; Şirin, Hadiye; Güler, Ayşe; Önder, Halil; Önder, Halil; Bektaş, Hesna; Ocek, Levent; Bakar, Mustafa; Ongün, Nedim; Krespi, Yakup; Işıkay, Canan Togay; Aslanbaba, Eda; Sorgun, Mine; Gürkas, Erdem; Karadeli, Hasan Hüseyin; Midi, İpek; Ilgezdı, İrem; Bilgiç, Adnan Burak; Akyol, Şener; Epceliden, M. Tuncay; Atmaca, Murat Mert; Kurşun, Oğuzhan; Keskin, Onur; Bekdik Şirinocak, Pınar; Baydemir, Recep; Akcakoyunlu, Merve; Öztürk, Şerefnur; Özel, Tuğba; Ünal, Ali; Dora, Babur; Yürekli, Vedat Ali; Arlıer, Zülfikar; Eren, Alper; Yılmaz, Ayşe; Kısabay, Ayşin; Acar, Bilgehan; Baştan, Birgül; Acar, Zeynep; Niflioğlu, Buket; Güven, Bülent; Kaya, Dilaver; Afşar, Nazire; Yazıcı, Duran; Aytaç, Emrah; Yaka, Erdem; Toplutaş, Eren; Değirmenci, Eylem; İnce, Fatma Birsen; Büyükşerbetçi, Gülseren; Aydın, İsa; Çetiner, Mustafa; Şen, Mustafa; Turgut, Nilda; Kale, Nilüfer; Çoban, Eda; Yeşilot, Nilüfer; Ekizoğlu, Esme; Kızek, Özgü; Birgili, Özlem; Yevgi, Recep; Kunt, Refik; Giray, Semih; Yazıcı Akkaş, Sinem; Şenadım, Songül; Yoldaş, Tahir; Asil, Talip; Duman, Taşkın; Atasoy, Tuğrul; Çınar, Bilge Piri; Demir, Tülin; Can, Ufuk; Ünsal, Yaprak Özüm; Eskut, Neslihan; Aslan, Yıldız; Baş, Demet Funda; Şener, Ufuk; Yılmaz, Zahide; Bozdoğan, Zehra; Alioğlu, Zekeriya; Arsava, Ethem Murat
    Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69±14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (?): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (?): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (?): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin’s scale score 0-2) functional outcome [exp (?): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (?): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method.