Predictors of Wojner and Alexandrov for Placement of a Feeding Tube in a Stroke Patient with Dysphagia

 

Predictors for enteral tube placement:

(1) presence of a "wet voice" after swallowing water

(2) hypoglossal nerve dysfunction

(3) high National Institute of Health Stroke Scale (NIHSS)

(4) incomplete oral labial closure

 

where:

• Incomplete oral labial closure (putting the lips together) is an indicator of facial nerve motor tone (Table 1, page 533).

• The NIHSS ranges from 0 to 36, with a high score indicating a more severe stroke.

• The glossopharyngeal nerve is evaluated based on lateral, anterior and posture tongue movements and the ability to elevate the tongue against the hard palate (Table 1, page 533).

Predictor	Odds Ratio for Feeding Tube
hypoglossal nerve dysfunction	13
NIHSS	1.24 * (NIHSS)
wet voice after water	30
incomplete oral labial closure	73

 

where:

• The odds ratio for NIHSS is given on page 537 (1.24 times each NIHSS point score). An alternative is to raise 1.24 to a power equal to the NIHSS; an NIHSS score of 36 would indicate an odds ratio of 2307. Multiplying 1.24 * 36 = 45.