The simple and fast swallowing function assessment in acute stroke patients

Area of Science:

• Neurology
• Gastroenterology
• Pulmonology

Background:

• Dysphagia and pulmonary aspiration are significant causes of mortality and morbidity in stroke patients.
• Early and accurate assessment of swallowing function is crucial for stroke patient management.

Purpose of the Study:

• To evaluate early swallowing functions in acute ischemic stroke patients.
• To determine optimal feeding strategies using simple bedside tests.

Main Methods:

• Seventy-three acute stroke inpatients were assessed using bedside clinical evaluation of swallowing function (BDS) tests, including the assessment of dysphagia with neurological examination score (DSNE), bedside water drinking test (BWT), and Swallowing score (SS) ratio.
• Patients were also evaluated using the Gugging Swallowing Screen (GUSS) test for comparison.
• Aspiration pneumonia was monitored for seven days post-admission.

Main Results:

• BDS tests indicated that 74% of patients could be fed orally, 13.7% via nasogastric (NG) tube, and 11% via percutaneous endoscopic gastrostomy (PEG) tube.
• 41.1% of patients were identified at risk for aspiration, and 23.3% developed aspiration pneumonia.
• Dysphagia was identified in 30.1% of patients by GUSS, 23.3% by DSNE, and 30.1% by BWT.

Conclusions:

• Bedside clinical evaluation of swallowing function (BDS) tests are fast, reliable, and clinically applicable methods for assessing dysphagia and aspiration risk in hospitalized stroke patients.
• These simple tests offer an alternative to more complex methods like endoscopic or video fluoroscopy for evaluating swallowing function.