Article

OBJECTIVE: To simplify the cough test to screen silent aspiration without
sacrificing accuracy. DESIGN: Criterion standard. SETTING: University dental
hospital. PARTICIPANTS: Consecutive patients (N=141; 92 men, 49 women; mean age
71+/-14y, range 23-94y) who had complained of some dysphagic symptoms between
June 2008 and February 2010. INTERVENTIONS: All patients were administrated a
simplified cough test and underwent the fiberoptic endoscopic evaluation of
swallowing. Citric acid inhalation was terminated when the first cough occurred,
and the time between the start of inhalation and the first cough was measured.
MAIN OUTCOME MEASURES: The time when the first cough was observed by the
simplified cough test was compared with the results of the fiberoptic endoscopic
evaluation of swallowing, which was used as a criterion standard. RESULTS:
Receiver operating characteristic curve analysis was performed for 53 patients
evaluated as having aspiration by fiberoptic endoscopic evaluation of swallowing.
We found that 30 seconds or less was an appropriate cutoff value for detecting
patients without silent aspiration, where the sensitivity was .92 and the
specificity was .94. From the receiver operating characteristic curve analyses
for all patients, 60 seconds or less was determined to be an appropriate cutoff,
and the sensitivity and specificity were .81 and .65, respectively. CONCLUSION:
The simplified cough test is a useful screening tool for silent aspiration in
patients with aspiration.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS