title: Reduced incidence of aspiration with spoon-thick consistency in stroke patients.
abstract: BACKGROUND
  Dysphagia and aspiration occur frequently in stroke patients. The aim of the present study was to evaluate 2 consistencies (liquid and spoon-thick/pudding-like) regarding the risk of aspiration and to determine the usefulness of a bedside speech therapy assessment to predict risk of aspiration.
  
  
  METHODS
  This randomized, crossover clinical trial was carried out April to August 2001 at a university hospital. Sixty-one inpatients diagnosed with acute phase or prior stroke received liquid and spoon-thick (pudding-like) feeds during nasoendoscopy and bedside clinical assessment.
  
  
  RESULTS
  Aspiration occurred in only 3 patients with the spoon-thick consistency vs 21 with the liquid consistency (relative risk=0.13; 95% confidence interval=0.04-0.39; P<.001). The bedside assessment had a sensitivity of 81% and a specificity of 70.8% to detect risk of aspiration.
  
  
  CONCLUSIONS
  The use of a spoon-thick consistency reduced the risk of aspiration compared with the liquid consistency. Clinical assessment was useful to predict aspiration, although the probability of dysphagia in the presence of a negative clinical assessment (29%) is a reason for concern.
authors.affiliation: Universidade Federal do Rio Grande do Sul, 218, Comendador Albino cunha street, Porto Alegre, Brazil, 91040-040. claudia.cp@terra.com.br
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Diniz
authors.forename: Gabriela
authors.initials: G
authors.lastname: Vanin
authors.forename: Rogerio
authors.initials: R
authors.lastname: Xavier
authors.forename: Maria Alice
authors.initials: MA
authors.lastname: Parente
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D018592:Cross-Over Studies; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004032:Diet / Q000379:methods*; D005260:Female; D005502:Food; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D015994:Incidence; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D053120:Respiratory Aspiration / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013070:Speech Therapy / Q000379:methods; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D014783:Viscosity; D055815:Young Adult