Abstract Number: Esoc2026a1261 Critical Evaluation of Delay in Gastrostomy Tube Placement in Acute Stroke Patients

Abstract Background and aims Gastrostomy tube placement is recommended for acute stroke patients with persistent dysphagia, yet delays between decision and procedure are common, leading to prolonged hospitalization and delayed rehabilitation. This study aims to determine the proportion of stroke patients experiencing delayed gastrostomy tube placement and factors associated with these delays. Methods We retrospectively reviewed 84 consecutive acute stroke patients who underwent PEG placement during hospitalization over a two-year period. Patients were categorized as non-delayed (≤48 hours) or delayed (48 hours) based on interval between determination of need and procedure. Demographics, stroke characteristics, hospital length of stay, number of speech-language pathology (SLP) sessions, causes of delay, and discharge disposition were analyzed. Results Of 84 patients, 43 (51.8%) experienced delayed PEG placement (mean delay 4.8 ± 2.0 days). Weekend or holiday scheduling (46.5%) and antiplatelet therapy discontinuation (mean delay 6.5 ± 2.3 days) were the most common causes. Family hesitation accounted for 11.6% of delays (mean 5.6 ± 0.9 days). Patients with delayed placement had longer hospital stays (29.6 ± 14.7 vs. 24.0 ± 11.8 days, p = 0.06) and were less frequently discharged to rehabilitation (27.9% vs. 40.0%) compared with non-delayed patients. Delayed placement was associated with a higher proportion of discharge to long-term acute care (23.3% vs. 17.5%) or hospice/in-hospital death (21.0% vs. 12.5%). Conclusions We found that over half of acute stroke patients who are recommended for gastrostomy tube placement experience a delay in receiving the procedure with weekend scheduling and need for discontinuing antiplatelet agents as major contributors to the observed delay. Conflict of interest Gunjanpreet Kaur: Nothing to disclose