Screening of swallowing disorders in stroke: Utility of clinical signs and clinical examination method of volume-viscosity in comparison with videofluoroscopy

A. Guillén-Solà, J. Martínez-Orfila, R. Boza Gómez, S. Monleón Castelló, E. Marco

    Research output: Contribution to journalArticleResearchpeer-review

    6 Citations (Scopus)

    Abstract

    Introduction: The presence of dysphagia has been associated to dehydration, nutritional disorders, pneumonia and even death of the patient, this having an affect on the health care costs. There are methods to detect dysphagia early based on evaluation of the clinical signs and methods that can be used at the bedside of the patient. Objectives: To determine the utility of the evaluation of the clinical signs (CS) and the volume-viscosity test (V-VST) and evaluate their efficacy to detect risk of aspiration in the acute and subacute phase of stroke. Patients and method: A retrospective evaluation of a cohort of 79 stroke patients was performed. We compared the clinical signs and V-VST with the results observed with the videofluoroscopy (VFC). The variables that determine accuracy and overall value of a diagnostic method, that is, sensitivity, specificity, and positive (PPV) and negative (NPP) predictive values, were calculated. Results: A sensitivity of 69% and specificity of 28.8% was obtained for the Clinical Signs to detect severe dysphagia (Aspiration). V-VST detected aspiration with 100% sensitivity and 13.6% specificity. NPP was 62.5% and 100%, respectively. Diagnostic accuracy was 0.38 for clinical signs and 0.48 for V-VST. Conclusion: Using CS and V-VST for the evaluation of the dysphagic patient is a low-cost screening method that is easy to apply and highly sensitive. The V-VST offers a higher sensitivity, specificity and accuracy and makes it possible to modify the diet early and to decide whether instrumental assessment is indicated. © 2011 Elsevier España, S.L. y SERMEF. Todos los derechos reservados.
    Original languageEnglish
    Pages (from-to)292-300
    JournalRehabilitacion
    Volume45
    Issue number4
    DOIs
    Publication statusPublished - 1 Oct 2011

    Keywords

    • Dysphagia
    • Rehabilitation
    • Screening test
    • Stroke
    • Videofluoroscopy

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