title: Detection of aspiration and swallowing disorder in older stroke patients: simple swallowing provocation test versus water swallowing test.
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.
  
  
  METHODS
  Retrospective comparative study involving a simple 2-step SPT and WST on all subjects.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  SPT is more useful than WST in differentiating patients predisposed to aspiration.
authors.affiliation: Department of Internal Medicine, San-no Hospital, International University of Health & Welfare, Tokyo, Japan. shinjit-tky@umin.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Teramoto
authors.forename: Y
authors.initials: Y
authors.lastname: Fukuchi
mesh_terms: D000368:Aged; D002986:Clinical Trials as Topic; D003679:Deglutition; D005260:Female; D005683:Gagging; D006801:Humans; D008297:Male; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications*; D014867:Water
chemical_list: D014867:Water