S Teramoto1, Y Fukuchi. 1. Department of Internal Medicine, San-no Hospital, International University of Health & Welfare, Tokyo, Japan. shinjit-tky@umin.ac.jp
Abstract
OBJECTIVE: To assess the sensitivity and specificity of a simple swallowing provocation test (SPT) and a water swallowing test (WST) in detecting aspiration pneumonia in elderly patients with stroke. DESIGN: Retrospective comparative study involving a simple 2-step SPT and WST on all subjects. PARTICIPANTS: Twenty-six stroke patients with aspiration pneumonia (mean age, 72.1 +/- 4.1 yr) and 26 age-matched stroke patients without aspiration pneumonia (mean age, 69.4 +/- 3.9 yr). INTERVENTIONS: The normal response to SPT was determined by inducing swallowing reflex within 3 seconds after water injection into the suprapharynx. In WST, subjects drank quantities of 10 and 30 mL of water from a cup within 10 seconds. The subject who drank water without interruption-without evidence of aspiration-was determined as normal. RESULTS: The sensitivity and specificity of first-step SPT for the detection of aspiration pneumonia were 100% and 83.8%, respectively. Those of the second-step SPT were 76.4% and 100%, respectively. The sensitivity and specificity of first-step WST using 10 mL of water for the detection of aspiration pneumonia were 71.4% and 70.8%, respectively. Those of the second-step WST using 30 mL of water were 72% and 70.3%, respectively. CONCLUSION: SPT is more useful than WST in differentiating patients predisposed to aspiration.
OBJECTIVE: To assess the sensitivity and specificity of a simple swallowing provocation test (SPT) and a water swallowing test (WST) in detecting aspiration pneumonia in elderly patients with stroke. DESIGN: Retrospective comparative study involving a simple 2-step SPT and WST on all subjects. PARTICIPANTS: Twenty-six strokepatients with aspiration pneumonia (mean age, 72.1 +/- 4.1 yr) and 26 age-matched strokepatients without aspiration pneumonia (mean age, 69.4 +/- 3.9 yr). INTERVENTIONS: The normal response to SPT was determined by inducing swallowing reflex within 3 seconds after water injection into the suprapharynx. In WST, subjects drank quantities of 10 and 30 mL of water from a cup within 10 seconds. The subject who drank water without interruption-without evidence of aspiration-was determined as normal. RESULTS: The sensitivity and specificity of first-step SPT for the detection of aspiration pneumonia were 100% and 83.8%, respectively. Those of the second-step SPT were 76.4% and 100%, respectively. The sensitivity and specificity of first-step WST using 10 mL of water for the detection of aspiration pneumonia were 71.4% and 70.8%, respectively. Those of the second-step WST using 30 mL of water were 72% and 70.3%, respectively. CONCLUSION: SPT is more useful than WST in differentiating patients predisposed to aspiration.
Authors: R Dziewas; M Ritter; M Schilling; C Konrad; S Oelenberg; D G Nabavi; F Stögbauer; E B Ringelstein; P Lüdemann Journal: J Neurol Neurosurg Psychiatry Date: 2004-06 Impact factor: 10.154