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:

Conclusions reached by Gupta et al. and MedPAC In November of 2017 Ankur Gupta and 10 other experts in cardiovascular medicine published an article in JAMA Cardiology entitled, “Association of the Hospital Readmissions Reduction Program implementation with readmission and mortality outcomes in heart failure.” The authors were affiliated with well-known universities, and three of them were also editors of JAMA Cardiology [4]. Their research was financed by grants from the NIH and Get With the Guidelines-Heart Failure (GWTG-HF), a “voluntary quality improvement program” sponsored by the Amer...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medicare Politics CMS Congress hospital readmissions HRRP Kip Sullivan MedPAC P4P Pay for Performance Source Type: blogs
Conclusions reached by Gupta et al. and MedPAC In November of 2017 Ankur Gupta and 10 other experts in cardiovascular medicine published an article in JAMA Cardiology entitled, “Association of the Hospital Readmissions Reduction Program implementation with readmission and mortality outcomes in heart failure.” The authors were affiliated with well-known universities, and three of them were also editors of JAMA Cardiology [4]. Their research was financed by grants from the NIH and Get With the Guidelines-Heart Failure (GWTG-HF), a “voluntary quality improvement program” sponsored by the Amer...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medicare Politics CMS Congress hospital readmissions HRRP Kip Sullivan MedPAC P4P Pay for Performance Source Type: blogs
ConclusionsIn the overall analysis and observational studies, CS was associated with improved functional outcomes and relatively safe for anterior ischemic stroke compared with GA. While the pooled data from RCTs suggested that GA was associated with improved outcomes. The inconsistency indicated that more large ‐scale RCTs are required to evaluate what factors influenced the effect of the anesthesia methods on clinical outcomes.
Source: Brain and Behavior - Category: Neurology Authors: Tags: REVIEW ARTICLE Source Type: research
Authors: Yarlagadda M, Shen M, Abraham A, Mousavi I, Sethi MK Abstract The purpose of this study was to identify those complications for which patients with adverse cardiac events are at risk within the 30-day postoperative period following treatment oforthopaedic trauma cases. This was a retrospective cohort study of orthopaedic trauma patients in the United States between 2006 and 2013. A total of 56,336 patients meeting any one of 89 CPT codes in the American College of Surgeons National Surgical Quality Improvement Program database were used. The main outcome measure was myocardial infarction or cardiac arrest ...
Source: Journal of surgical orthopaedic advances - Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research
By Susan Scutti, CNN (CNN) — Life expectancy in the United States declined from 2016 to 2017, yet the 10 leading causes of death remained the same, according to three government reports released Thursday. Increasing deaths due to drug overdoses and suicides explain this slight downtick in life expectancy, the US Centers for Disease Control says. Overdose deaths reached a new high in 2017, topping 70,000, while the suicide rate increased by 3.7%, the CDC’s National Center for Health Statistics reports. Dr. Robert Redfield, CDC director, called the trend tragic and troubling. “Life expectancy give...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health News CNN Source Type: news
U.S. life expectancy dropped in 2017 for the third consecutive year, as deaths by suicide and drug overdose continue to claim more American lives. The average American could expect to live to 78.6 years old in 2017, down from 78.7 in 2016, according to data released Thursday by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). That decline may be modest, but it marks the third year in a row that life expectancy at birth has fallen — a noteworthy phenomenon, since the previous multiyear drop recorded by the NCHS was in the early 1960s. The modern trend seems to be pr...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized healthytime onetime public health Source Type: news
In this study, we reviewed the outcome of SCD patients who underwent transplant at our institution using standard protocols (NMA regimen in patients ≥14 years and myeloablative regimen in
Source: Blood - Category: Hematology Authors: Tags: 732. Clinical Allogeneic Transplantation: Results: Poster II Source Type: research
Conclusions: TPOa use in the real world setting confirms their reported efficacy, the option to switch and/or re-treat with either EPAG or ROMI, and the possibility to discontinue the drugs. The presence of hypocellularity and megakaryocytopenia, along with dysplastic features and of a lymphoid T cell infiltrate are associated with a reduced response to TPOa and a shorter RFS. Pre-treatment bone marrow evaluation may give hints to unravel the physiopathologic mechanisms underlying TPOa refractoriness.DisclosuresRossi: MUNDIPHARMA: Honoraria; JANNSEN: Other; AMGEN: Other: ADVISORY BOARD; PFIZER: Other: ADVISORY BOARD; BMS: ...
Source: Blood - Category: Hematology Authors: Tags: 311. Disorders of Platelet Number or Function: Poster III Source Type: research
ConclusionContinuous tracking in a single center observational study demonstrated that continuous HU therapy starting in infancy maintained Hgb and Hgb F at or above pre-HU levels into childhood, is associated with no hospitalizations after age 3 and no ED visits for pain after HU initiation by age 1. No acute chest syndrome requiring oxygen or transfusion, no abnormal or conditional TCD, and no overt strokes occurred in this cohort. Implementation of HU for children with sickle cell disease starting in infancy is feasible in the community and is effective in maintaining high fetal hemoglobin and preventing disease complic...
Source: Blood - Category: Hematology Authors: Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster III Source Type: research
Conclusions:Erythrocytopharesis (Automated RBC exchange) is effective, quick and safe procedure that is life saving for many patients with ACS and is associated with less difficulties and complications if compared with the manual exchange. Because SCA is a national problem in Saudi Arabia and acute chest syndrome and other acute major complications comprehensively kill SCD patients, Automated Erythocytopharesis should be available nation-wide like dialysis machines at all large hospitals in all cities and should be distributed according to the prevalence of SCA in the area or location.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - Category: Hematology Authors: Tags: 114. Hemoglobinopathies, Excluding Thalassemia-Clinical Source Type: research
More News: Brain | Canada Health | Hospitals | Neurology | Nurses | Nursing | Pathology | Pneumonia | Speech Therapy | Speech-Language Pathology | Stroke | Study