G Kolb1, M Bröker. 1. St. Bonifatius-Hospital, Akad. Lehrkrankenhs, Med. Hochschule Hannover, Lingen/Ems. gerald.kolb@bonifatius-lingen.de
Abstract
BACKGROUND: Dysphagia is a common but severe complication in acute stroke. New bedside tests are necessary to assess the risk of aspiration and avoid unnecessary alimentary restrictions but they must be completed by evaluated instruments. OBJECTIVE: We evaluated the prognostic validity of the recognition of forms (rf) test related to the assessment by speech and language therapists (SLT). DESIGN: Double blinded screening tests. SETTING:Geriatric department of general hospital. SUBJECTS:50 patients with acute stroke admitted consecutively. METHODS: All patients were assessed by SLT, mini mental status test, short test for assessing deficits of memory and attention and abilities of daily living-test. The rf-test was performed twice with a two week interval. RESULTS: Assessment by SLT demonstrated aspiration in 29 of 50 patients. 18 patients failed the rf-test, giving a specificity of 90% (positive predictive value 89%), a sensitivity of 55% (negative predictive value 59%). 5 of 7 patients with aspiration pneumonia failed the test. Test-retest-correlation was 0,827. Performance in the rf-test was related significantly to results of the activities of daily living-test. CONCLUSIONS: Bedside tests to exclude aspiration in patients with acute stroke are necessary. No test so far combines high sensitivity with acceptable specificity. Compared to other bedside tests the rf-test has a high specificity while sensitivity is low. On behalf of good predictivity rf-test may be an interesting supplement to swallow tests in case of stroke and seems to be a candidate for more extended studies.
RCT Entities:
BACKGROUND:Dysphagia is a common but severe complication in acute stroke. New bedside tests are necessary to assess the risk of aspiration and avoid unnecessary alimentary restrictions but they must be completed by evaluated instruments. OBJECTIVE: We evaluated the prognostic validity of the recognition of forms (rf) test related to the assessment by speech and language therapists (SLT). DESIGN: Double blinded screening tests. SETTING: Geriatric department of general hospital. SUBJECTS: 50 patients with acute stroke admitted consecutively. METHODS: All patients were assessed by SLT, mini mental status test, short test for assessing deficits of memory and attention and abilities of daily living-test. The rf-test was performed twice with a two week interval. RESULTS: Assessment by SLT demonstrated aspiration in 29 of 50 patients. 18 patients failed the rf-test, giving a specificity of 90% (positive predictive value 89%), a sensitivity of 55% (negative predictive value 59%). 5 of 7 patients with aspiration pneumonia failed the test. Test-retest-correlation was 0,827. Performance in the rf-test was related significantly to results of the activities of daily living-test. CONCLUSIONS: Bedside tests to exclude aspiration in patients with acute stroke are necessary. No test so far combines high sensitivity with acceptable specificity. Compared to other bedside tests the rf-test has a high specificity while sensitivity is low. On behalf of good predictivity rf-test may be an interesting supplement to swallow tests in case of stroke and seems to be a candidate for more extended studies.
Authors: Abtin Tabaee; Paul E Johnson; Carolyn J Gartner; Kevin Kalwerisky; Rosemary B Desloge; Michael G Stewart Journal: Laryngoscope Date: 2006-05 Impact factor: 3.325
Authors: Daniela Rejane Constantino Drozdz; Cintia Conceição Costa; Paulo Roberto de Oliveira Jesus; Mateus Silva Trindade; Guilherme Weiss; Abdias Baptista M Neto; Ana Maria T da Silva; Renata Mancopes Journal: Int Arch Otorhinolaryngol Date: 2012-10