title: Handgrip strength and dysphagia assessment following cardiac surgery.
abstract: OBJECTIVE
  Prolonged intubation has been recognized as a risk factor for dysphagia following cardiac surgery. We conducted a study to determine whether those patients intubated longer than 12 hours following cardiac surgery exhibit low handgrip strength and if dysphagia is prevalent in those with low handgrip strength.
  
  
  METHODS
  Feasibility study.
  
  
  METHODS
  Patients intubated more than 12 hours after cardiac surgery were enrolled. Handgrip strength was measured. If subjects were found to have low grip strength they underwent clinical swallowing exam by a speech-language pathologist followed by modified barium swallow (MBS) to assess for dysphagia. Severity of dysphagia was assessed with the Penetration-Aspiration Scale (PAS) and need for diet modification.
  
  
  RESULTS
  Eighty-six percent (12/14) of patients tested had low handgrip strength. Eight patients with low grip strength completed the bedside swallowing exam and MBS. Four of the eight patients (50%) had deep laryngeal penetration (PAS scores 4-5) on MBS and three (38%) patients were found to have silent aspiration (PAS 8). The findings on MBS resulted in the recommendation of a swallowing strategy and/or modified diet for six of the eight (80%) patients. Nonoral feedings were recommended for two patients (25%) based on MBS results.
  
  
  CONCLUSIONS
  A majority of patients intubated >12 hours after cardiac surgery exhibit low handgrip strength. Dysphagia is prevalent among those with low handgrip strength. The role of frailty measures in screening for dysphagia deserves further investigation.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Bridget
authors.initials: B
authors.lastname: Hathaway
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Brooke
authors.initials: B
authors.lastname: Baumann
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Sara
authors.initials: S
authors.lastname: Byers
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Tamara
authors.initials: T
authors.lastname: Wasserman-Wincko
authors.affiliation: Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Vinay
authors.initials: V
authors.lastname: Badhwar
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Jonas
authors.initials: J
authors.lastname: Johnson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005240:Feasibility Studies; D016330:Frail Elderly; D018737:Hand Strength; D006801:Humans; D007441:Intubation, Gastrointestinal; D008875:Middle Aged; D011184:Postoperative Period
keywords: Dysphagia; frailty; handgrip; intubation