© American Speech-Language-Hearing Association
Clinical Assessment of Swallowing and Prediction of Dysphagia Severity
1 Department of Veteran Affairs Medical Center and Tulane University School of Medicine, New Orleans
2 Alton Ochsner Medical Foundation, New Orleans
daniels.stephanie_k{at}new-orleans.med.va.gov
Dysphagia with aspiration is prevalent in acute stroke; however, noninvasive clinical screening assessments to identify patients at risk of developing aspiration are limited. This study was undertaken to determine whether risk factors detected in the clinical examination approximated the videofluoroscopic swallow study (VSS) in identification of dysphagia severity. Six clinical features—dysphonia, dysarthria, abnormal volitional cough, abnormal gag reflex, cough after swallow, and voice change after swallow—were assessed by means of an oropharyngeal evaluation and a clinical swallowing examination. Clinical assessments and VSS were completed on consecutive stroke patients (n=59) within 5 days of hospital admission. The VSS was scored on a scale of 0 to 4 (0=normal, 1=mild, 2=moderate, 3=moderate-severe, 4=severe dysphagia). Results showed that the presence of at least 2 of the 6 clinical features consistently distinguished patients with moderate to severe dysphagia from patients with mild dysphagia/normal swallowing. These data demonstrate that this clinical dysphagia screening tool can provide objective criteria for the need for VSS in acute stroke patients.
Key Words: stroke, dysphagia, aspiration, clinical swallowing assessment, videofluoroscopic swallow study
Submitted on July 7, 1997
Accepted on September 4, 1997
CiteULike 
Connotea 
Delicious 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  N. J. Donovan, S. K. Daniels, J. Edmiaston, J. Weinhardt, D. Summers, P. H. Mitchell, and on behalf of the American Heart Association Counci Dysphagia Screening: State of the Art: Invitational Conference Proceeding From the State-of-the-Art Nursing Symposium, International Stroke Conference 2012 Stroke, April 1, 2013; 44(4): e24 - e31. [Full Text] [PDF]
|
|
|
|
|
|
S. K. Daniels, J. A. Anderson, and P. C. Willson Valid Items for Screening Dysphagia Risk in Patients With Stroke: A Systematic Review Stroke, March 1, 2012; 43(3): 892 - 897. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Malandraki, J. A. Hind, R. Gangnon, J. A. Logemann, and J. Robbins The Utility of Pitch Elevation in the Evaluation of Oropharyngeal Dysphagia: Preliminary Findings Am J Speech Lang Pathol, November 1, 2011; 20(4): 262 - 268. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Edmiaston, L. T. Connor, L. Loehr, and A. Nassief Validation of a Dysphagia Screening Tool in Acute Stroke Patients Am. J. Crit. Care., July 1, 2010; 19(4): 357 - 364. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. B. Diniz, G. Vanin, R. Xavier, and M. A. Parente Reduced Incidence of Aspiration With Spoon-Thick Consistency in Stroke Patients Nutr Clin Pract, June 1, 2009; 24(3): 414 - 418. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Warnecke, I. Teismann, S. Oelenberg, C. Hamacher, E. B. Ringelstein, W. R. Schabitz, and R. Dziewas The Safety of Fiberoptic Endoscopic Evaluation of Swallowing in Acute Stroke Patients Stroke, February 1, 2009; 40(2): 482 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Crary and M. E. Groher Reinstituting Oral Feeding in Tube-Fed Adult Patients With Dysphagia Nutr Clin Pract, December 1, 2006; 21(6): 576 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Dziewas, M Ritter, M Schilling, C Konrad, S Oelenberg, D G Nabavi, F Stogbauer, E B Ringelstein, and P Ludemann Pneumonia in acute stroke patients fed by nasogastric tube J. Neurol. Neurosurg. Psychiatry, June 1, 2004; 75(6): 852 - 856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J.C. Ramsey, D. G. Smithard, and L. Kalra Early Assessments of Dysphagia and Aspiration Risk in Acute Stroke Patients Stroke, May 1, 2003; 34(5): 1252 - 1257. [Abstract] [Full Text] [PDF]
|
|