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Karger_ESC London_2013

22. European Stroke Conference 688 Acute stroke: clinical patterns and practice Did the Lancet FOOD trial have a noticeable effect on the placement of Percutaneous Endo-scopic Gastrostomy (PEG) tube in patients admitted with a stroke to a UK District General Hospital? K. Thavanesan1, O.J. David2, S.D. McLaughlin3 Royal Bournemouth and Christchurch Hospital Foundation Trust, Bournemouth, UNITED KINGDOM1, Royal Bournemouth and Christchurch Hospital Foundation Trust, Bournemouth, UNITED KINGDOM2, Royal Bournemouth and Christchurch Hospital Foundation Trust, Bour-nemouth, UNITED KINGDOM3 Background: Percutaneous Endoscopic Gastrostomy (PEG) feeding is a wide spread method of maintaining pa-tients nutritional requirements when the mechanism of swallowing is damaged following a stroke. The Lancet FOOD trial published in 2005 has had a significant impact in the management of nutri-tion in stroke patients. We sought to examine our local hospital’s experience to see what impact the FOOD trial has had on the use of PEG feeding post stroke. Methods A retrospective analysis of all PEG procedures from January 2005 to September 2012 was per-formed, and data isolated for the number of PEG tubes inserted in patients with a confirmed stroke each year. We reviewed the timing between stroke and PEG placement and the subsequent one year survival. Results Of the total 259 patients with PEG tube placements within the hospital, 130 (50%) were inserted in stroke patients. On average the hospital has 600 stroke patients per year of which <5% received a PEG tube. Following publication of the FOOD trial this number has dropped to 2.8% yearly. The mean time to PEG insertion increased to 30 days (Range 18.8-48.2 days). One year mortality in stroke patients with a PEG in-use decreased from 12/25 (48%) deaths in 2005 to an average of 30% in subsequent years (Range 11.8%-43.8%). Conclusion Following the FOOD trial, there has been a non-statistically significant change in the use of PEGs within the hospital’s stroke population; however these preliminary findings are limited by the small sample size. There is furthermore, an overall non-significant decline in the number of PEG tubes placed with longer periods for review prior to PEG insertion; and the yearly mortality of stroke pa-tients with PEG tube in-use has reduced. This could be attributed to other changes whereby stroke patients are admitted to the acute stroke unit directly, thereby receiving specialist assessment prior to PEG placement. These findings support the notion that the FOOD trial has influenced practice. 710 © 2013 S. Karger AG, Basel Scientific Programme 689 Acute stroke: clinical patterns and practice Stroke Patterns in rural south india . A One years Experience in a rural stroke centre . S. VANCHILINGAM1, V. SOMESH2, V. KARTHIKEYAN3, D. K. THANGADURAI4 KSDC HOSPITAL ,, THANJAVUR, INDIA1, KSDC HOSPITAL, THANJAVUR, INDIA2, KSDC HOSPITAL, THANJAVUR, INDIA3, KSDC HOSPITAL, THANJAVUR, INDIA4 Background : To study the incidence of stroke among general neurology patient population , identify stroke sub types , identify prevalent risk factors , identify feasibility of thrombolysis. Methods : In this retrospective study from 1st april2011 to 31st mar 2012 , all patients who got ad-mitted for stroke were analysed for age,sex,risk factors,stroke sub types ,and patients who were eli-gible for thrombolysis . Results : Study done at KSDC Hospital , Thanjavur , rural south India ,Total number of patients was 33328 . In patient admissions was 1970 , Stroke admissions were 859 ,both ischemic and hem-orrhagic. Acute Ischemic stroke were 576 ,age range (2 yrs -91yrs) . Risk factors Diabetes (24%) , Hypertension (19%) , Dyslipidemia (19%) , Tobacco and Alcohol (46%) . Large artery anterior cir-culation strokes were seen in (54%) and posterior circulation strokes in (30%) and lacunar strokes in (14%) .13% of the patients were eligible for thrombolysis of which 7.5% had IV thrombolysis . ICH accounted for 18% with an age range of 14-86 yrs .Systemic hypertension was seen in 62% and diabetes in 15% . 75% of were parenchymal ICH , ICH with IVH in 18% and isolated IVH in 6 %. Cerebral venous sinus thrombosis accounted for 9 % with Age range 6-73yrs . Risk factors included Post partum (15%) ,OC pill intake (6%) in females , Alcoholism in males at 38% , Fever with de-hydration seen in 26% and CNS cellulitis with thrombosis in 2% .Sub Arachnoid hemorrhage was seen in 3% with Age range 23-80yrs .57% of SAH were aneurysmal bleeds and 33% had hyperten-sion . 3 % of the total strokes were SDH , age range was 26-80yrs . 95% were post traumatic and 5% were anticoagulant induced . Conclusion: On analysing the data we found that 43% of the total admissions were for stroke , 67% were ischemic ,18% ICH and IVH , Cerebral venous thrombosis 9% ,SAH 3 % , SDH 3% .13% of ischemic stroke patients were eligible for thrombolysis out of which 7.5% were thrombolysed.


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