Patient selection: stroke patient with post-stroke swallowing disorder
Outcome: aspiration, chest infection and/or swallowing impairment in the 6 months after stroke. Patients with swallowing impairment often had not returned to prestroke diet.
Patient assessment: clinical exam and videofluorscopy of swallowing
Parameters:
(1) gender
(2) age
(3) oral transit on videofluoroscopy
(4) pentration of contrast into the laryngeal vestibule on videofluoroscopy
|
Parameter
|
Finding
|
Points
|
|
gender
|
female
|
0
|
|
|
male
|
1
|
|
age in years
|
<= 70 years
|
0
|
|
|
> 70 years
|
1
|
|
oral transiet
|
normal
|
0
|
|
|
delayed
|
1
|
|
penetrating of contrast into laryngeal vestibule
|
no
|
0
|
|
|
yes
|
1
|
where:
• The odds ratios for age and gender were each 5. The odds ratios for oral transient and contrast penetration were each 14.
number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The greater the number of risk factors the more likely that the patient will have an adverse outcome within 6 months.
• Delayed or absent swallowing reflex was associated with chest infection.
• Delayed oral transit on videofluoroscopy was associated with a failure to return to a normal diet.
