Muscari et al reported the DIsPHAGIc score for evaluating a patient with post-stroke dysphagia. This can help to identify a patient who failure of swallowing recovery. The authors are from multiple institutions in Italy.
DIsPHAGIc is an acronym for diameter, ischemia, partial, hypoxia, antiplatelet, GCS and internal capsule.
Patient selection: post-stroke dysphagia
Parameters:
(1) diameter of cerebral lesion in cm
(2) left frontal ischemia
(3) partial anterior circulation syndrome
(4) hypoxia
(5) antiplatelet drug
(6) GCS verbal score, from 1 to 5
(7) internal capsule ischemia
|
Parameter
|
Finding
|
Points
|
|
diameter of cerebral lesion
|
< 6 cm
|
0
|
|
|
>= 6 cm
|
1
|
|
left frontal ischemia
|
no
|
0
|
|
|
yes
|
-1
|
|
partial anterior circulation syndrome
|
no
|
0
|
|
|
yes
|
-1
|
|
hypoxia
|
no
|
0
|
|
|
yes
|
1
|
|
antiplatelet drug
|
no
|
0
|
|
|
yes
|
1
|
|
GCS verbal score
|
< 4
|
1
|
|
|
>= 4
|
0
|
|
internal capsule ischemia
|
no
|
0
|
|
|
yes
|
-1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -3
• maximum score: 4
• A score >= 2 is associated with a high risk of nonrecovery of swallowing.
Performance:
• At the cutoff of >= 2, the sensitivity is 72% and specificity 76%, with diagnostic accuracy of 75%.
