title: Five days of successful oral alimentation for hospitalized patients based upon passing the Yale Swallow Protocol.
abstract: OBJECTIVE
  This study aimed to determine the success of oral alimentation and patient retention rate 1 to 5 days after passing the Yale Swallow Protocol.
  
  
  METHODS
  Participants were 200 consecutive acute care inpatients referred for swallow assessment. Inclusion criteria were adequate cognitive abilities to participate safely, completing an oral mechanism examination, and passing the 3-ounce water swallow challenge. Exclusion criteria were altered mental status, failing the 3-ounce challenge, preadmission dysphagia, head-of-bed restrictions < 30°, and a tracheotomy tube. Electronic medical record monitoring post-protocol passing for 1 to 5 consecutive days determined success of oral alimentation and retention rate.
  
  
  RESULTS
  All patients who remained medically and neurologically stable drank thin liquids and ate successfully 1 to 5 days after passing the protocol. Mean (SD) volume of liquid ingested per day was 474.2 (435.5) cc. Patient retention declined steadily from day of testing (n = 200) through post-testing day 5 (n = 95).
  
  
  CONCLUSIONS
  Passing the Yale Swallow Protocol allowed for initial determination of aspiration risk followed by successful oral alimentation for 1 to 5 days in medically and neurologically stable acute care hospitalized patients and without the need for instrumental dysphagia testing. The decline in patient retention was expected because of increasingly rapid transit through the acute care setting, which often renders longer follow-up problematic.
authors.affiliation: Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA steven.leder@yale.edu.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Leder
authors.affiliation: Veterans Affairs Medical Center, Memphis, Tennessee, USA.
authors.forename: Debra M
authors.initials: DM
authors.lastname: Suiter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000178:diet therapy / Q000209:etiology; D003937:Diagnosis, Differential; D004032:Diet; D004326:Drinking; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome; D014867:Water
chemical_list: D014867:Water
keywords: aspiration risk; deglutition; deglutition disorders; oral alimentation; swallow screening