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Does a 3‐Sip Test Detect Dysphagia in Acute Stroke Rehabilitation Patients?
Author(s) -
Kopey Stephanie A.,
Chae John,
Vargo Mary M.
Publication year - 2010
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2010.05.015
Subject(s) - dysphagia , medicine , stroke (engine) , rehabilitation , physical therapy , predictive value , predictive value of tests , acute stroke , logistic regression , retrospective cohort study , surgery , mechanical engineering , tissue plasminogen activator , engineering
Objectives (1) Evaluate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a 3‐sip test within 24 hours of acute stroke as a screening for clinically relevant dysphagia during acute rehabilitation. (2) For those patients who pass the 3‐sip test, identify factors predictive of later detection of clinically relevant dysphagia. Design A retrospective review. Setting Acute stroke rehabilitation unit of a tertiary academic medical center. Patients 223 patients undergoing dysphagia screening after stroke. Main Outcome Measure Development of clinically relevant dysphagia. Results Seventeen of 223 patients (7.6%) failed the 3‐sip test. Of the 206 patients who passed the 3‐sip test, 57 (27.7%) manifested clinically relevant dysphagia. Sensitivity and specificity of the 3‐sip test were 20.8% and 98.7%, respectively. PPV and NPV were 88.2% and 72.3%, respectively. Among those who passed the 3‐sip test, logistic regression identified the Functional Independence Measure (FIM) total score as the only independent predictor (B = −0.066, P < .001) of clinically relevant dysphagia. Of those patients who passed the 3‐sip test, 54.6% with an FIM total score <60 had clinically relevant dysphagia compared with 11.9% with an FIM total score >60. Conclusions The sensitivity of the 3‐sip test was poor for stroke rehabilitation patients. For those who passed the 3‐sip test, a low FIM total score was predictive of development of clinically relevant dysphagia. A high degree of clinical suspicion for dysphagia should remain after passing a 3‐sip screening test, especially for those with FIM total score <60.