State of the art in aspiration assessment and the idea of a new non invasive predictive test for the risk of aspiration in stroke.
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).


METHODS
Double blinded screening tests.


METHODS
Geriatric department of general hospital.


METHODS
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.
Kolb
G
G
St. Bonifatius-Hospital, Akad. Lehrkrankenhs, Med. Hochschule Hannover, Lingen/Ems. gerald.kolb@bonifatius-lingen.de
Bröker
M
M
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis*; D004311:Double-Blind Method; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D053120:Respiratory Aspiration / Q000175:diagnosis* / Q000209:etiology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013070:Speech Therapy; D020521:Stroke / Q000150:complications*