Turkish Journal of Geriatrics 2022 , Vol 25, Issue 1
COMPARISON OF BEDSIDE DIAGNOSIS METHODS WITH FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING IN PATIENTS WITH POST-STROKE DYSPHAGIA
Levent YÜCEL1, Umut EROL1, Nimet EVİN2, Büşra YELEĞEN1, Mahmut Sami BİÇİMVEREN3, Ülkühan DÜZGÜN3, Hakan GENÇ1
1 University of Health Sciences, Gülhane Training and Research Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Ankara, Turkey
2University of Health Sciences, Gülhane Training and Research Hospital, Division of Swallowing Pathology, Department of Otorhinolaryngology, Ankara, Turkey
3University of Health Sciences, Gülhane Training and Research Hospital, Department of Neurology, Ankara, Turkey DOI : 10.31086/tjgeri.2022.260 Introduction: Post-stroke dysphagia increases mortality and morbidity due to aspiration pneumonia and malnutrition. We aimed to compare the applicability of the bedside water swallow test, the National Institutes of Health Stroke Scale, and the modified Mann Assessment of Swallowing Ability with the fiberoptic endoscopic evaluation of swallowing in determining dysphagia.

Materials and Methods: Our study included 40 patients admitted to a tertiary hospital from July to October 2021 with acute ischemic stroke. We prospectively noted each patient"s age, gender, medical conditions, test scores, and the presence of pneumonia during hospitalization.

Results: Of the 40 patients, 27 (67.5%) were male and 13 (32.5%) female, and their mean age was 68.72 years. Eleven (27.5%) patients had aspiration, 6 (15%) had penetration, and 17 (42.5%) had therefore dysphagia. A statistically significant difference was noted between the patients with and without dysphagia for the bedside water swallow test, the modified Mann Assessment of Swallowing Ability, 2% or more oxygen desaturation, the combination of the bedside water swallow test and the modified Mann Assessment of Swallowing Ability, and saturation (p = 0.004, p = 0.03, p = 0.042, p = 0.002, and p = 0.042, respectively). A statistically significance for the prediction of aspiration (p = 0.049) was only detected using the bedside water swallowing test?modified Mann Assessment of Swallowing Ability combination.

Conclusion: Bedside dysphagia screening may be used to determine the presence of post-stroke dysphagia. Notwithstanding, only the bedside water swallowing test?modified Mann Assessment of Swallowing Ability combination successfully predicted aspiration. Keywords : Dysphagia; Endoscopy; Pneumonia; Stroke