Abstract Background and aims The benefits of nasogastric tube (NGT) feeding in stroke are well established1, but evidence is lacking regarding NGT feeding in the older cohort where care goals and overall prognosis may differ from studied populations. Our study identifies admission characteristics that could indicate an increased risk of poorer outcomes despite NGT feeding; to aid decision-making in post-stroke dysphagia management for older people with frailty. Methods A retrospective cohort analysis conducted over January to February 2025. Inclusion criteria were patients aged ≥ 65 years, with an acute stroke, and failed bedside swallow assessment. Results A total of 38 patients met criteria. Mean age was 83.2 years (SD +/- 7.1 years). Modal modified Rankin Scale was 3 and median Rockwood Score was 5. Mean baseline NIHSS was 16.9 (SD +/- 9.6/IQR 11). 42% had a pre-existing dementia diagnosis or history of cognitive decline. 52% had an NGT inserted. Of these, 40% had oropharyngeal dysphagia and 55% had a low conscious level. Of those with dementia/history of cognitive decline who received NGT feeding, 60% did not survive admission and 100% died by 90 days. Of those with a Rockwood Score of ≥ 5 who received NGT feeding, 83% died by 9 months. Conclusions High mortality rates suggest that patients with a Rockwood Score ≥ 5 or pre-existing dementia/history of cognitive decline are more likely to be approaching the last year of life, even with NGT feeding. This highlights the importance of developing the evidence base for post-stroke dysphagia management for older people with frailty. Conflict of interest Dr. Su Ling Yeoh: nothing to disclose. Dr. Lady-Namera Alexander: nothing to disclose. Dr. Sadia Saber: nothing to disclose.
Yeoh et al. (Fri,) studied this question.