Abstract Details

Title Spontaneous Swallow Frequency as a Screening Protocol for Dysphagia in Acute Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S32 - (-)

Poster/Presentation
Number 004

Objective

Background Dysphagia screening in acute stroke facilitates reduced pneumonia rates. Current dysphagia screening protocols incorporate subjective clinical examinations. Spontaneous swallow frequency is evaluated as an objective approach to dysphagia screening in acute stroke.

Design/Methods Cross sectional study of acute stroke patients. Spontaneous swallow frequency was evaluated by a simple acoustic monitor. Dysphagia was identified by standardized examination for dysphagia (Mann Assessment of Swallow Ability: MASA). Stroke severity estimated by the NIHSS, Rankin Scale, and Barthel Index. Sensitivity, specificity and classification accuracy were calculated for identification of dysphagia based on spontaneous swallow frequency. ROC analysis estimated a cut point for spontaneous swallow frequency to identify dysphagia. Correlations were used to evaluate relations among stroke severity, dysphagia, and spontaneous swallow frequency.

Results From a cohort of 64 acute stroke cases, 24 patients demonstrated clinically significant dysphagia. Mean spontaneous swallow frequency for patients with dysphagia was 0.23 swallows per minute vs. 0. 52 swallows per minute for stroke cases without dysphagia (t= 4.76; p < 0.0001). ROC analysis identified a swallow frequency of 0.40 swallows per minute as a reasonable cut point to identify dysphagia (AUC = 0.81; p < 0.0001). At this cut point, sensitivity was estimated at 91.7 and specificity at 55.0. Overall classification accuracy was estimated at 71%. The odds of correctly identifying dysphagia based on this cutpoint was high (OR = 14.8). In this cohort, spontaneous swallow frequency was not significantly correlated with age (-.204), but was significantly correlated with NIHSS (-.45; p = 0.004), modified Barthel Index (.45; p <0.001), modified Rankin Scale (-.51; p< 0.001), and presence of dysphagia (MASA: .47; p< 0.001).

Conclusions Results of this intiatial study indicate that spontaneous swallow frequency is a strong indicator of dysphagia in acute stroke.

Authors/Disclosures
Michael Crary PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Shauna Gysin (Neurostatus Systems AG)	No disclosure on file

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