Patient selection: chronic neurologic disorder with significant disability
Parameters:
(1) nasogastric or gastric feeding tube
(2) hyperextended neck (elevation of the chin above the horizontal plane with resistance to efforts to return the chin to the normal position)
(3) contractures (easily observed permanent muscular contractions)
(4) malnutrition
(5) therapy with benzodiazepine
(6) therapy with anticholinergic drug
|
Parameter
|
Finding
|
Points
|
|
feeding tube
|
absent
|
0
|
|
|
present
|
1
|
|
hyperextended neck
|
absent
|
0
|
|
|
present
|
1
|
|
contractures
|
absent
|
0
|
|
|
present
|
1
|
|
malnutrition
|
absent
|
0
|
|
|
present
|
1
|
|
therapy with benzodiazepine
|
absent
|
0
|
|
|
present
|
1
|
|
therapy with anticholinergic drug
|
absent
|
0
|
|
|
present
|
1
|
where:
• Malnutrition was diagnosed when 2 or 3 of the following criteria were present: (a) body weight less than 90% of ideal body weight for height, (b) serum albumin < 3.5 g/dL, and (c) hemoglobin < 12 g/dL without other cause.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 6
• The risk of pulmonary aspiration increases with the number of risk factors.
