title: Lowering bronchoaspiration rate in an acute stroke unit by means of a 2 volume/3 texture dysphagia screening test with pulsioximetry.
abstract: BACKGROUND
  During acute stroke, 30% of all patients present dysphagia and 50% of that subgroup will experience bronchoaspiration. Our aim was to compare mortality and bronchoaspiration rates associated with the water test compared to those associated with a 2 volume/3 texture test controlled with pulse oximetry (2v/3t-P test) in our stroke unit.
  
  
  METHODS
  Over a 5-year period, we performed a prospective analysis of all consecutive acute ischaemic stroke patients hospitalised in the Stroke Unit. Dysphagia was evaluated using the water test between 2008 and 2010 (group 0 or G0), and the 2v/3t-P test (group 1 or G1) between 2011 and 2012. We analysed demographic data, vascular risk factors, neurological deficit on the NIHSS, aetiological subtype according to TOAST criteria, clinical subtype according to the Oxfordshire classification, prevalence of dysphagia, percentage of patients with bronchoaspiration, and mortality.
  
  
  RESULTS
  We examined 418 patients with acute stroke (G0=275, G1=143). There were significant differences between the 2 groups regarding the percentage of patients with TACI (17% in G0 vs. 29% in G1, P=.005) and median NIHSS score (4 points in G0 vs. 7 points in G1, P=.003). Since adopting the new swallowing test, we detected a non-significant increase in the percentage of dysphagia (22% in G0 vs. 25% in G1, P=.4), lower mortality (1.7% in G0 vs. 0.7% in G1, P=.3) and a significant decrease in the bronchoaspiration rate (6.2% in G0 vs. 2.1% in G1, P=.05).
  
  
  CONCLUSIONS
  Compared to the water test used for dysphagia screening, the new 2v/3t-P test lowered bronchoaspiration rates in acute stroke patients.
authors: Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España. Electronic address: lolacocho@gmail.com.
authors: D
authors: D
authors: Cocho
authors: Servicio de Farmacia, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: M
authors: M
authors: Sagales
authors: Servicio de Logopedia, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: M
authors: M
authors: Cobo
authors: Servicio de Otorrinolaringología, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: I
authors: I
authors: Homs
authors: Servicio de Otorrinolaringología, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: J
authors: J
authors: Serra
authors: Servicio de Rehabilitación, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: M
authors: M
authors: Pou
authors: Servicio de Enfermería, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: G
authors: G
authors: Perez
authors: Servicio de Enfermería, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: G
authors: G
authors: Pujol
authors: Servicio de Enfermería, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: S
authors: S
authors: Tantinya
authors: Servicio de Geriatría, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: P
authors: P
authors: Bao
authors: Departamento de Calidad, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: A
authors: A
authors: Aloy
authors: Departamento de Calidad, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: R
authors: R
authors: Sabater
authors: Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: J
authors: J
authors: Gendre
authors: Servicio de Neurología, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Barcelona, España.
authors: P
authors: P
authors: Otermin
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications*
keywords: Acute ischaemic stroke; Bronchoaspiration; Broncoaspiración; Disfagia; Dysphagia; Infarto cerebral; Mortalidad; Mortality