title: Fiberoptic endoscopic Dysphagia severity scale predicts outcome after acute stroke.
abstract: OBJECTIVE
  Fiberoptic endoscopic evaluation of swallowing (FEES) is a suitable method for dysphagia assessment after acute stroke. Recently, we developed the fiberoptic endoscopic dysphagia severity scale (FEDSS) for acute stroke patients, grading dysphagia into 6 severity codes (1 to 6; 1 being best). The purpose of this study was to investigate the impact of the FEDSS as a predictor of outcomes at 3 months and intermediate complications during acute treatment.
  
  
  METHODS
  A total of 153 consecutive first-ever acute stroke patients were enrolled. Dysphagia was classified according to the FEDSS, assessed within 24 h after admission. Intermediate outcomes were pneumonia and endotracheal intubation. Functional outcome was measured by the modified Rankin Scale (mRS) at 3 months. Multivariate regression analysis was used to identify whether the FEDSS was an independent predictor of outcome and intercurrent complications. Analyses were adjusted for sex, age and National Institutes of Health Stroke Scale (NIH-SS) on admission.
  
  
  RESULTS
  The FEDSS was found to predict the mRS at 3 months as well as but independent from the NIH-SS. For each additional point on the FEDSS, the likelihood of dependency at 3 months (mRS > or = 3) raised by approximately 50%. Each increase of 1 point on the FEDSS conferred a more than 2-fold increased chance of developing pneumonia. The odds for the necessity of endotracheal intubation raised by a factor of nearly 2.5 with each additional point on the FEDSS.
  
  
  CONCLUSIONS
  The FEDSS strongly and independently predicts outcome and intercurrent complications after acute stroke. Thus, a baseline FEES examination provides valuable prognostic information for the treatment of acute stroke patients.
authors.affiliation: Department of Neurology, University Hospital of Munster, Munster, Germany. Tobias.Warnecke@ukmuenster.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Warnecke
authors.forename: Martin A
authors.initials: MA
authors.lastname: Ritter
authors.forename: Bjelka
authors.initials: B
authors.lastname: Kroger
authors.forename: Stephan
authors.initials: S
authors.lastname: Oelenberg
authors.forename: Inga
authors.initials: I
authors.lastname: Teismann
authors.forename: Peter U
authors.initials: PU
authors.lastname: Heuschmann
authors.forename: E Bernd
authors.initials: EB
authors.lastname: Ringelstein
authors.forename: Darius G
authors.initials: DG
authors.lastname: Nabavi
authors.forename: Rainer
authors.initials: R
authors.lastname: Dziewas
mesh_terms: D000208:Acute Disease; D000368:Aged; D002545:Brain Ischemia / Q000150:complications; D002543:Cerebral Hemorrhage / Q000150:complications; D003627:Data Interpretation, Statistical; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D055100:Optical Fibers; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012121:Respiration, Artificial; D020521:Stroke / Q000150:complications* / Q000175:diagnosis*; D016896:Treatment Outcome