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Laryngopharyngeal Sensory Testing With Modified Barium Swallow As Predictors of Aspiration Pneumonia After Stroke
Author(s) -
Aviv Jonathan E.,
Sacco Ralph L.,
Mohr J.P.,
Thompson J.L.P.,
Levin Bruce,
Sunshine Susan,
Thomson Jeanne,
Close Lanny G.
Publication year - 1997
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199709000-00018
Subject(s) - medicine , stroke (engine) , aspiration pneumonia , pneumonia , surgery , sensory system , mechanical engineering , psychology , engineering , cognitive psychology
Improved diagnostic tests that can accurately identify subjects at high risk for aspiration pneumonia (AP) are needed. One measure of this accuracy is the false‐negative rate (FNR), which determines the failure of a test to identify a group at high risk. This study compares FNRs for AP among dysphagic stroke patients for two prognostic techniques: modified barium swallow (MBS) alone and MBS combined with laryngopharyngeal sensory discrimination testing(MBS + LPSDT). MBS and LPSDT were performed within 4 weeks of stroke in 20 subjects who were prospectively followed for at least 2 years to identify the frequency of AP. MBS identified 10 patients as not at risk based on the finding of no aspiration on initial MBS; four of these patients developed AP (FNR = 40%). MBS + LPSDT identified five patients as not at risk based on the findings of neither aspiration nor bilateral sensory deficits; none of these patients developed AP (FNR = 0%). The combination of MBS criterion (aspiration) with the LPSDT criterion (bilateral sensory deficits) improves prognostication of outcome in dysphagic stroke patients by identifying a subgroup at high risk for developing AP (nonaspirators with bilateral deficits).