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. 2010 Jul;19(4):357-64.
doi: 10.4037/ajcc2009961. Epub 2009 Oct 29.

Validation of a dysphagia screening tool in acute stroke patients

Jeff Edmiaston  1 , Lisa Tabor Connor, Lynda Loehr, Abdullah Nassief
Affiliations

Validation of a dysphagia screening tool in acute stroke patients

Jeff Edmiaston et al. Am J Crit Care. 2010 Jul.

Abstract

Background: Although many dysphagia screening tools exist, none has high sensitivity and reliability or can be administered quickly with minimal training.

Objective: To design and validate a swallowing screening tool to be used by health care professionals who are not speech language pathologists to identify dysphagia and aspiration risk in acute stroke patients.

Methods: In a prospective study of 300 patients admitted to the stroke service at an urban tertiary care hospital, interrater and test-retest reliabilities of a new tool (the Acute Stroke Dysphagia Screen) were established. The tool was administered by nursing staff when patients were admitted to the stroke unit. A speech language pathologist blinded to the results with the new tool administered the Mann Assessment of Swallowing Ability, a clinical bedside evaluation, with dysphagia operationally defined by a score less than 178.

Results: The mean time from admission to screening with the new tool was 8 hours. The mean time between administration of the new tool and the clinical bedside evaluation was 32 hours. For the new tool, interrater reliability was 93.6% and test-retest reliability was 92.5%. The new tool had a sensitivity of 91% and a specificity of 74% for detecting dysphagia and a sensitivity of 95% and a specificity of 68% for detecting aspiration risk.

Conclusions: The Acute Stroke Dysphagia Screen is an easily administered and reliable tool that has sufficient sensitivity to detect both dysphagia and aspiration risk in acute stroke patients.

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Figures

Figure
Figure
Screening tool developed to detect difficulty swallowing in stroke patients.
See this image and copyright information in PMC

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