Screening protocol for dysphagia in adults: comparison with videofluoroscopic findings

Authors

  • Fernanda C. Sassi Universidade de São Paulo; Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP); Departamento de Fisioterapia
  • Gisele C. Medeiros Universidade de São Paulo; Hospital das Clínicas HCFMUSP, Faculdade de Medicina; Divisão de Fonoaudiologia
  • Bruno Zilberstein Universidade de São Paulo; Hospital das Clinicas HCFMUSP, Faculdade de Medicina; Divisao de Cirurgia Digestiva
  • Shri Krishna Jayanthi Universidade de São Paulo; Hospital das Clinicas HCFMUSP, Faculdade de Medicina; Instituto de Radiologia
  • Claudia R.F. de Andrade Universidade de São Paulo; Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina (FMUSP); Departamento de Fisioterapia

DOI:

https://doi.org/10.6061/clinics/2017(12)01

Keywords:

Dysphagia, Screening Test, Modified Barium Swallow, Aspiration, Pneumonia

Abstract

OBJECTIVES: To compare the videofluoroscopic findings of patients with suspected oropharyngeal dysphagia with the results of a clinical screening protocol. METHODS: A retrospective observational cohort study was conducted on all consecutive patients with suspected oropharyngeal dysphagia between March 2015 and February 2016 who were assigned to receive a videofluoroscopic assessment of swallowing. All patients were first submitted to videofluoroscopy and then to the clinical assessment of swallowing. The clinical assessment was performed within the first 24 hours after videofluoroscopy. The videofluoroscopy results were analyzed regarding penetration/aspiration using an 8-point multidimensional perceptual scale. The accuracy of the clinical protocol was analyzed using the sensitivity, specificity, likelihood ratios and predictive values. RESULTS: The selected sample consisted of 50 patients. The clinical protocol presented a sensitivity of 50% and specificity of 95%, with an accuracy of 88%. “Cough” and “wet-hoarse” vocal quality after/during swallowing were clinical indicators that appeared to correctly identify the presence of penetration/aspiration risk. CONCLUSION: The clinical protocol used in the present study is a simple, rapid and reliable clinical assessment. Despite the absence of a completely satisfactory result, especially in terms of the sensitivity and positive predictive values, we suggest that lower rates of pneumonia can be achieved using a formal dysphagia screening method.

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Published

2017-12-01

Issue

Section

Clinical Sciences

How to Cite

Sassi, F. C., Medeiros, G. C., Zilberstein, B., Jayanthi, S. K., & de Andrade, C. R. (2017). Screening protocol for dysphagia in adults: comparison with videofluoroscopic findings. Clinics, 72(12), 718-722. https://doi.org/10.6061/clinics/2017(12)01