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Usefulness of the volume-viscosity swallow test for screening dysphagia in subacute stroke patients in rehabilitation income

GUILLEN SOLA A; MARCO E; MARTINEZ ORFILA J; DONAIRE MEJIAS MF; DEPOLO PASSALACQUA M; DUARTE E; ESCALADA F
NEUROREHABILITATION , 2013, vol. 33, n° 4, p. 631-638
Doc n°: 166589
Localisation : Centre de Réadaptation de Lay St Christophe

D.O.I. : http://dx.doi.org/DOI:10.3233/NRE-130997
Descripteurs : AF21 - ACCIDENTS VASCULAIRES CEREBRAUX, AD35 - DYSPHAGIE

Swallowing disorders affect up to 35-85% of patients with stroke.
Dysphagia complications can lead to malnutrition, dehydration, bronchoaspirative
pneumonia and death, and have impact on health care costs. OBJECTIVE: To evaluate
the clinical screening capacity of the Volume Viscosity Swallow Test (V-VST) for
oropharyngeal dysphagia and aspiration in a homogeneous stroke patient sample.
METHODS: Cohort study of 52 stroke patients in a subacute phase. Piecemeal
deglutition and oropharyngeal residue were considered signs of impaired efficacy
and cough, fall in oxygen saturation and voice changes, signs of impaired safety.
Sensitivity, specificity, positive and negative predictive values, accuracy and
likelihood ratios were calculated for V-VST results and compared with those of
videofluoroscopy (VFS), the gold standard for studies on swallowing disorders.
RESULTS: The V-VST is a highly sensitive and specific test to detect aspiration
with sensitivity of 88.2% and specificity of 71.4%; negative predictive value was
92.6%; accuracy index was 0.74. Sensitivity and specificity for penetration were
34.3% and 70.6%, respectively; accuracy was 32%. CONCLUSIONS: The V-VST is low in
cost, easy to use and very sensitive, meeting the requirements of oropharyngeal
dysphagia and aspiration screening test in subacute stroke patients.

Langue : ANGLAIS

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