Reduced Incidence of Aspiration With Spoon‐Thick Consistency in Stroke Patients

Background: Dysphagia and aspiration occur frequently in stroke patients. The aim of the present study was to evaluate 2 consistencies (liquid and spoon‐thick/pudding‐like) regarding the risk of aspiration and to determine the usefulness of a bedside speech therapy assessment to predict risk of aspiration. Methods: This randomized, crossover clinical trial was carried out April to August 2001 at a university hospital. Sixty‐one inpatients diagnosed with acute phase or prior stroke received liquid and spoon‐thick (pudding‐like) feeds during nasoendoscopy and bedside clinical assessment. Results: Aspiration occured in only 3 patients with the spoon‐thick consistency vs 21 with the liquid consistency (relative risk = 0.13; 95% confidence interval = 0.04–0.39; P < .001). The bedside assessment had a sensitivity of 81% and a specificity of 70.8% to detect risk of aspiration. Conclusions: The use of a spoon‐thick consistency reduced the risk of aspiration compared with the liquid consistency. Clinical assessment was useful to predict aspiration, although the probability of dysphagia in the presence of a negative clinical assessment (29%) is a reason for concern.