Article

OBJECTIVE: To develop and validate a nurse-administered screening tool to
identify aspiration risk in patients with suspected stroke.
DESIGN: Validity study comparing evidence-based swallowing screening items with the
videofluoroscopic swallowing study (VFSS) results.
SETTING: A certified primary
stroke center in a major metropolitan medical facility. PARTICIPANTS: Consecutive
patients (N=250) admitted with suspected stroke. INTERVENTIONS: Patients were
administered evidence-based swallowing screening items by nurses. A VFSS was
completed within 2 hours of swallowing screening. MAIN OUTCOME MEASURES: Validity
relative to identifying VFSS-determined aspiration for each screening item and
for various combinations of items. RESULTS: Aspiration was identified in 29 of
250 participants (12%). Logistic regression revealed that age (P=.012),
dysarthria (P=.001), abnormal volitional cough (P=.030), and signs related to the
water swallow trial (P=.021) were significantly associated with aspiration.
Validity was then determined on the basis of the best combination of significant
items for predicting aspiration. The results revealed that age >70 years,
dysarthria, or signs related to the water swallow trial (ie, cough, throat clear,
wet vocal quality, and inability to continuously drink 90mL water) yielded 93%
sensitivity and 98% negative predictive value. CONCLUSIONS: The final validated
tool, Rapid Aspiration Screening for Suspected Stroke, is a valid
nurse-administered tool to detect risk of aspiration in patients presenting with
suspected stroke.
CI - Published by Elsevier Inc.

Langue : ANGLAIS