Rapid Aspiration Screening for Suspected Stroke: Part 1: Development and Validation.
To develop and validate a nurse-administered screening tool to identify aspiration risk in patients with suspected stroke.



Validity study comparing evidence-based swallowing screening items with the videofluoroscopic swallowing study (VFSS) results.



A certified primary stroke center in a major metropolitan medical facility.



Consecutive patients (N=250) admitted with suspected stroke.



Patients were administered evidence-based swallowing screening items by nurses. A VFSS was completed within 2 hours of swallowing screening.



Validity relative to identifying VFSS-determined aspiration for each screening item and for various combinations of items.



Aspiration was identified in 29 of 250 participants (12%). Logistic regression revealed that age (P=.012), dysarthria (P=.001), abnormal volitional cough (P=.030), and signs related to the water swallow trial (P=.021) were significantly associated with aspiration. Validity was then determined on the basis of the best combination of significant items for predicting aspiration. The results revealed that age >70 years, dysarthria, or signs related to the water swallow trial (ie, cough, throat clear, wet vocal quality, and inability to continuously drink 90mL water) yielded 93% sensitivity and 98% negative predictive value.



The final validated tool, Rapid Aspiration Screening for Suspected Stroke, is a valid nurse-administered tool to detect risk of aspiration in patients presenting with suspected stroke.
Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Department of Communication Sciences and Disorders, University of Houston, Houston, TX. Electronic address: skdaniels@uh.edu.
Stephanie K
SK
Daniels
School of Public Health, University of Texas Health Sciences Center, Houston, TX.
Shweta
S
Pathak
Department of Communication Sciences and Disorders, University of Florida, Gainesville, FL.
John C
JC
Rosenbek
School of Public Health, University of Texas Health Sciences Center, Houston, TX.
Robert O
RO
Morgan
Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; Department of Neurology, Baylor College of Medicine, Houston, TX.
Jane A
JA
Anderson
D000367:Age Factors; D000368:Aged; D003371:Cough; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis* / Q000451:nursing; D004401:Dysarthria / Q000150:complications / Q000175:diagnosis; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D053120:Respiratory Aspiration / Q000150:complications / Q000175:diagnosis* / Q000451:nursing; D020521:Stroke / Q000150:complications / Q000175:diagnosis* / Q000451:nursing
Deglutition; Deglutition disorders; Rehabilitation; Stroke