Kyung Hee Moon; Hyun Sook Sohn; Eun Seok Lee; Eun Kyung Paek; Eun Ju Kang; Seung Hee Lee; Na Ri Han; Meen Hye Lee; Deog Young Kim; Chang Gi Park; Ji-Soo Yoo

doi:10.4040/jkan.2010.40.3.359

Articles

Page Path: HOME > J Korean Acad Nurs > Volume 40(3); 2010 > Article

Original Article
Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients: Kyung Hee Moon, Hyun Sook Sohn, Eun Seok Lee, Eun Kyung Paek, Eun Ju Kang, Seung Hee Lee, Na Ri Han, Meen Hye Lee, Deog Young Kim, Chang Gi Park, Ji-Soo Yoo; Journal of Korean Academy of Nursing 2010;40(3):359-366.
DOI: https://doi.org/10.4040/jkan.2010.40.3.359
Published online: June 30, 2010

¹Director, Division of Nursing, Severance Hospital, Seoul, Korea.

²Registered Nurse, Department of Nursing, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

³Associate Professor, Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.

⁴Researcher, University of Illinois at Chicago, IL, USA.

⁵Professor, College of Nursing · Researcher, Nursing Policy Research Institute, Yonsei University, Seoul, Korea.

Address reprint requests to: Yoo, Ji-Soo. College of Nursing, Yonsei University, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-3252, Fax: 82-2-392-5440, yoojs48@yuhs.ac

• Received: December 21, 2009 • Accepted: May 25, 2010

13 Views
1 Download
4 Scopus

prev next

Full Article

Download PDF

Abstract
REFERENCES

Abstract

Purpose
The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool.
Methods
A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis.
Results
In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy.
Conclusion
The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.
Keywords: Deglutition disorders; Risk assessment; Aspiration; Fluoroscopy

REFERENCES

1. Daniels SK, Ballo LA, Mahoney MC. Clinical predictors of dysphagia and aspiration risk: Outcome measures in acute stoke patients. Archives of Physical Medicine and Rehabilitation. 2000;81:1030–1033.Article PubMed
2. Erdfelder E, Faul F, Buchner A. GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers. 1996;28:1–11.Article PDF
3. Han TR, Paik NJ, Park JW. The functional dysphagia scale using videofluoroscopic swallowing study in stroke patients. Journal of Korean Academy of Rehabilitation Medicine. 1999;23:1118–1126.
4. Han TR, Paik NJ, Park JW. The clinical functional scale for dysphagia in stroke patients. Korean Journal of Stroke. 2001;3:153–157.
5. Jung SH, Lee KJ, Hong JB, Han TR. Validation of clinical dysphagia scale: Based on videofluoroscopic swallowing study. Journal of Korean Academy of Rehabilitation Medicine. 2005;29:343–350.
6. Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: Incidence, diagnosis, and pulmonary complications. Stroke. 2005;36:2756–2763.Article PubMed
7. Massey R, Jedlicka DJ. The massey bedside swallowing screening. Journal of Neuroscience Nursing. 2002;34:257–260.
8. Muller R, Möckel M. Logistic regression and CART in the analysis of multimarker studies. Clinica Chimica Acta. 2008;394:1–6.Article
9. Nishiwaki K, Tsuji T, Liu M, Hase K, Tanaka N, Fujiwara T. Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple dysphagia variables. Journal of Rehabilitation Medicine. 2005;37:247–251.Article PubMed
10. Paek EK, Moon KH, Kim HJ, Lee ES, Sohn HS, Yoo JS, et al. Dysphagia assessment tool for post-stroke patients. Clinical Nursing Research. 2007;13(3):19–30.
11. Paik NJ, Kim IS, Kim JH, Oh BM, Han TR. Clinical validity of the functional dysphagia scale based on videofluoroscopic swallowing study. Journal of Korean Academy of Rehabilitation Medicine. 2005;29:43–49.
12. Park CI, Moon JH, Kang SW, Park ES, Shin JC, Kim DY, et al. Rehabilitation Medicine. 2008;2nd ed. Seoul, Hanmibook.
13. Ramsey DJ, Smithard DG, Kalra L. Early assessments of dysphagia and aspiration risk in acute stoke patients. Stroke. 2003;34:1252–1257.Article PubMed

Figure 1

CART model of the dysphagia assessment tool.

1^*=Abnormal; 2^*=Normal; V49=Aspiration; V15=Cough during swallowing; V13=Oral stasis; V23=Facial symmetry; V31=Salivary drooling; V16=Cough after swallowing; CART=Classification and Regression Tree.

Table 1

General Characteristics of Patients (N=202)

Table 2

Diseases Related Characteristics of Patients (N=202)

^*Missing responses excluded.

Table 3

Characteristics Related to Videofluoroscopy (N=202)

^*Missing responses excluded.

Table 4

Revised Dysphagia Assessment Tool

Table 5

Comparison of Risk Estimate Error of Aspiration in Revised Dysphagia Assessment Tool and Videofluoroscopy (N=202)

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients

J Korean Acad Nurs. 2010;40(3):359-366. Published online June 30, 2010

DOI: https://doi.org/10.4040/jkan.2010.40.3.359

XML Download

Figure

We recommend

Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients

Figure 1 CART model of the dysphagia assessment tool. 1*=Abnormal; 2*=Normal; V49=Aspiration; V15=Cough during swallowing; V13=Oral stasis; V23=Facial symmetry; V31=Salivary drooling; V16=Cough after swallowing; CART=Classification and Regression Tree.

Figure 1

Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients

Table 1

General Characteristics of Patients (N=202)

Table 2

Diseases Related Characteristics of Patients (N=202)

^*Missing responses excluded.

Table 3

Characteristics Related to Videofluoroscopy (N=202)

^*Missing responses excluded.

Table 4

Revised Dysphagia Assessment Tool

Table 5

Comparison of Risk Estimate Error of Aspiration in Revised Dysphagia Assessment Tool and Videofluoroscopy (N=202)

Table 1 General Characteristics of Patients (N=202)

Table 2 Diseases Related Characteristics of Patients (N=202)

^*Missing responses excluded.

Table 3 Characteristics Related to Videofluoroscopy (N=202)

^*Missing responses excluded.

Table 4 Revised Dysphagia Assessment Tool

Table 5 Comparison of Risk Estimate Error of Aspiration in Revised Dysphagia Assessment Tool and Videofluoroscopy (N=202)