The Rapid Aspiration Screening in Suspected Stroke Part 1: Development and Validation.

The Rapid Aspiration Screening in Suspected Stroke Part 1: Development and Validation.

Arch Phys Med Rehabil. 2016 Apr 23;

Authors: Daniels SK, Pathak S, Rosenbek JC, Morgan RO, Anderson JA

Abstract
OBJECTIVES: To develop and validate a nurse-administered screening tool to identify aspiration risk in patients with suspected stroke.
DESIGN: Validity study comparing evidence-based swallowing screening items with videofluoroscopic swallowing study (VFSS).
SETTINGS: The study was completed in a certified primary stroke center in a major metropolitan medical facility.
PARTICIPANTS: Consecutive patients (N=250) admitted with suspected stroke.
INTERVENTIONS: Patients were administered evidence-based swallowing screening items by nurses. A VFSS was completed within 2 hours of swallowing screening.
MAIN OUTCOME MEASURE: Validity relative to identifying VFSS determined aspiration for each screening item and for various combinations of items.
RESULTS: Aspiration was identified in 29 of the 250 participants. Logistic regression revealed age (p=0.012), dysarthria (p=0.001), abnormal volitional cough (p=0.030), and signs related to trial water swallow (p=0.021) to be significantly associated with aspiration. Validity was then determined based on the best combination of significant items for predicting aspiration. Results revealed that age >70, or dysarthria, or signs related to trial water swallow (i.e., cough, throat clear, wet vocal quality, and inability to continuously swallow 90ml water) yielded 93% sensitivity and 98% negative predictive value.
CONCLUSIONS: The final validated tool, Rapid Aspiration Screening for Suspected Stroke (RAS(3)), is a valid nurse-administered tool to detect risk of aspiration in patients presenting with suspected stroke.

PMID: 27117382 [PubMed - as supplied by publisher]

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