Document Detail


A Simple Bedside Stroke Dysphagia Screen, Validated against Videofluoroscopy, Detects Dysphagia and Aspiration with High Sensitivity.
MedLine Citation:
PMID:  23910514     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Early identification of dysphagia is associated with lower rates of pneumonia after acute stroke. The Barnes-Jewish Hospital Stroke Dysphagia Screen (BJH-SDS) was previously developed as a simple bedside screen performed by nurses for sensitive detection of dysphagia and was previously validated against the speech pathologist's clinical assessment for dysphagia. In this study, acute stroke patients were prospectively enrolled to assess the accuracy of the BJH-SDS when tested against the gold standard test for dysphagia, the videofluoroscopic swallow study (VFSS).
METHODS: Acute stroke patients were prospectively enrolled at a large tertiary care inpatient stroke unit. The nurse performed the BJH-SDS at the bedside. After providing consent, patients then underwent VFSS for determination of dysphagia and aspiration. The VFSS was performed by a speech pathologist who was blinded to the results of the BJH-SDS. Sensitivity and specificity were calculated. Pneumonia rates were assessed across the 5-year period over which the BJH-SDS was introduced into the stroke unit.
RESULTS: A total of 225 acute stroke patients were enrolled. Sensitivity and specificity of the screen to detect dysphagia were 94% and 66%, respectively. Sensitivity and specificity of the screen to detect aspiration were 95% and 50%, respectively. No increase in pneumonia was identified during implementation of the screen (P = .33).
CONCLUSION: The BJH-SDS, validated against videofluoroscopy, is a simple bedside screen for sensitive identification of dysphagia and aspiration in the stroke population.
Authors:
Jeff Edmiaston; Lisa Tabor Connor; Karen Steger-May; Andria L Ford
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-7-30
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  -     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-8-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Rehabilitation, Barnes-Jewish Hospital, St Louis, Missouri. Electronic address: jme0544@bjc.org.
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