Document Detail

Assessment of swallowing and referral to speech and language therapists in acute stroke.
MedLine Citation:
PMID:  10024948     Owner:  NLM     Status:  MEDLINE    
The best clinical assessment of swallowing following acute stroke, in order to decide whether to refer a patient to a speech and language therapist (SLT), is uncertain. Independently of the managing clinical team, we prospectively investigated 115 patients (51 male) with acute stroke, mean age 75 years (range 24-94) within 72 h of admission, using a questionnaire, structured examination and timed water swallowing test. Outcome variables included referral to and intervention by a speech and language therapist (SLT), dietary modification, respiratory complications and death. Of those patients in whom an SLT recommended intervention, 97% were detected by an abnormal quantitative water swallowing test; specificity was 69%. An SLT was very unlikely to recommend any intervention if the test was normal. Inability to perform a water test and/or abnormality of the test was associated with significantly increased relative risks of death, chest infection and dietary modification. A timed water swallowing test can be a useful test of swallowing and may be used to screen patients for referral to a speech and language therapist after acute stroke.
N P Hinds; C M Wiles
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  91     ISSN:  1460-2725     ISO Abbreviation:  QJM     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-03-08     Completed Date:  1999-03-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  829-35     Citation Subset:  IM    
Department of Medicine (Neurology), University Hospital of Wales, Cardiff, UK.
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MeSH Terms
Acute Disease
Cerebrovascular Disorders / complications*
Deglutition Disorders / diagnosis,  etiology*
Referral and Consultation
Sensitivity and Specificity
Speech-Language Pathology*

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