A NEW study has revealed that severe dysphagia significantly worsens survival outcomes in patients who undergo percutaneous endoscopic gastrostomy (PEG). The research analysed data from 107 patients who received PEG between April 2016 and April 2021, aiming to determine the impact of severe swallowing impairment on overall survival.
Using the Hyodo–Komagane score, researchers classified patients into two groups: moderate dysphagia (score ≤8) and severe dysphagia (score ≥9). The findings were striking—patients with severe dysphagia had markedly worse survival rates compared to those with moderate dysphagia (p < 0.0001). After a median follow-up of 16.7 months, severe dysphagia was identified as an independent predictor of poor prognosis, with a hazard ratio of 2.956 (95% confidence interval: 1.592–5.489, p < 0.001).
The study further revealed that aspiration-related pneumonia was the most common cause of death following PEG. Given the strong correlation between severe dysphagia and increased mortality, the authors suggest that greater caution is needed when making decisions regarding PEG placement in patients with advanced swallowing impairment.
These findings reinforce the importance of early dysphagia assessment and careful consideration of alternative feeding strategies in high-risk patients. As PEG is often used in patients with neurodegenerative diseases, stroke, or other conditions affecting swallowing, this study highlights the need for multidisciplinary approaches to optimise patient outcomes.
Aleksandra Zurowska, EMJ
Reference
Shimamoto K et al. Impact of severe dysphagia on overall survival after percutaneous endoscopic gastrostomy. Sci Rep. 2025;DOI: 10.1038/s41598-025-88097-y.
