Screening for Dysphagia in Adult Patients with Stroke: Assessing the Accuracy of Informal Detection

This study assessed the accuracy of informal dysphagia detection prior to implementation of a formal screening protocol. We conducted a secondary analysis of data captured between 2003 and 2008 from a sample of 250 adult stroke survivors admitted to a tertiary care centre. Using a priori criteria, patient medical records were reviewed for notation about dysphagia; if present, the date/time of notation, writer ’s profession, and suggestion of dysphagia presence. To assess accuracy of notations indicating dysphagia presence, we used speech language pathology (SLP) assessments as the criterion reference. There were 221 patient medical records available for review. Patients were male (56%), averaged 68 ye ars (SD = 15.0), with a mean Canadian Neurological Scale score of 8.1 (SD = 3.0). First notations of swallowing by SLP were excluded. Of the remaining 170 patients, 147 (87%) had first notations (104 by nurses; 40 by physicians) within a median of 24.3 h from admission. Accuracy of detecting dy sphagia from informal notations was low, with a sensitivity of 36.7% [95% CI, 24.9, 50.1], but specificity was high (94.2% [95% CI, 86.5, 97.9]). Informal identification methods, although timely, are suboptimal in their accuracy to detect dysphagia and leave patients with stroke at risk for poor hea lth outcomes. Given these findings, we encourage the use of psychometrically validated formal screening protocols to identify dysphagia.
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

Related Links:

A person does not die directly from Alzheimer's disease; but instead, from complications caused by Alzheimer's disease.How do you know when a dementia patient is dying?Over time, and as Alzheimer's progresses, the body's immune system weakens, increasing susceptibility to infection and other causes of death related to the elderly.Typical complications from Alzheimer's and related dementia are:heart attacks, strokes, kidney failure, and lung infections due to aspiration of food. Multi-organ failure is often the cause of death in dementia patients.Learn More -Can you die from Alzheimer's disease?By Bob DeMarcoAlzheimer's Rea...
Source: Alzheimer's Reading Room, The - Category: Neurology Tags: alzheimer's alzheimer's care alzheimer's death Alzheimer's Dementia death alzheimer's dying alzheimer's dying dementia end of life caregiving family caergiving health searches related to alzheimer's Source Type: blogs
This study aims to assess the effect of using bedside fiber bronchoscope in sputum suction and alveolar lavage for treatment of stroke-associated pneumonia (SAP), compared with the use of conventional suction catheter. Methods One hundred and six patients with SAP were randomly divided into control group (n = 53) and experimental group (n = 53) for a controlled study. Patients in the two groups were conventionally treated with phlegm-resolving and anti-infective therapy. The conventional suction catheter was used for sputum suction for patients in the control group, while bedside fiber bronchoscope was ...
Source: Topics in Stroke Rehabilitation - Category: Neurology Authors: Tags: Top Stroke Rehabil Source Type: research
By SAURABH JHA Of my time arguing with doctors, 30 % is spent convincing British doctors that their American counterparts aren’t idiots, 30 % convincing American doctors that British doctors aren’t idiots, and 40 % convincing both that I’m not an idiot. A British doctor once earnestly asked whether American physicians carry credit card reading machines inside their white coats. Myths about the NHS can be equally comical. British doctors don’t prostate every morning in deference to the NHS, like the citizens of Oceania sang to Big Brother in Orwell’s dystopia. Nor, in their daily rounds, do the...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: OP-ED Uncategorized AlfieEvans Source Type: blogs
Authors: Watanabe Y, Higashi H, Inoue K, Aono J, Okura T, Higaki J, Ikeda S Abstract Paradoxical low-flow, low-gradient aortic stenosis (LFLG AS) is recognized as a subtype of aortic stenosis. A small left ventricular (LV) cavity with marked LV concentric remodeling leads to a reduced stroke volume in this condition. The case is reported of a paradoxical LFLG AS patient who was undergoing treatment for pulmonary hypertension (PH) and interstitial pneumonia associated with scleroderma. Echocardiography demonstrated enlargement of the right ventricle and a diminished LV cavity. Moreover, the aortic valve opening was ...
Source: Journal of Heart Valve Disease - Category: Cardiology Tags: J Heart Valve Dis Source Type: research
AbstractSilent aspiration is common after stroke and can lead to subsequent pneumonia. While standard bedside dysphagia assessments are ineffective at predicting silent aspiration, cough reflex testing (CRT) has shown promise for identifying patients at risk of silent aspiration. We investigated the impact of CRT on patient and service outcomes when embedded into a clinical pathway. 488 acute stoke patients were randomly allocated to receive either CRT or standard care (i.e. bedside assessment). Primary outcomes included confirmed pneumonia within 3  months post stroke and length of acute inpatient stay. Secondary out...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research
Authors: Beghi G, De Tanti A, Serafini P, Bertolino C, Celentano A, Taormina G Abstract Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3.9-44% ...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
Acta Neurologica Scandinavica, EarlyView.
Source: Acta Neurologica Scandinavica - Category: Neurology Authors: Source Type: research
The antiplatelet drug cilostazol decreases the risk of ischemic stroke recurrence in patients with chronic cerebral infarction. Additionally, cilostazol reduces the occurrence of pneumonia in these patients. The purpose of this study was to investigate whether cilostazol is effective for preventing pneumonia in patients with acute cerebral infarction.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
We describe the immunohistochemical profile of secreted and membrane-associated mucins to confirm the origin of the retention cysts from dilated excretory ducts of submucosal glands. To our knowledge, this is the first report to describe esophagitis cystica contributing to cause of death at autopsy.
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research
This review article concludes preventive antibiotics had no effect on functional outcome or mortality, but significantly reduced the risk of'overall'infections. This reduction was driven mainly by prevention of urinary tract infection; no effect for pneumonia was found.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
More News: Brain | Canada Health | Hospitals | Neurology | Nurses | Nursing | Pathology | Pneumonia | Speech Therapy | Speech-Language Pathology | Stroke | Study