The Functional Dysphagia Scale Using Videofluoroscopic Swallowing Study in Stroke Patients

ABSTRACT

OBJECTIVE: Early detection and identification of the aspiration in stroke patients are essential for the prevention of respiratory complications. The purpose of this study is to develop a simple, easy-to-use, quantifiable functional dysphagia scale for stroke patients using videofluoroscopic swallowing study findings. METHOD: Oral and pharyngeal videofluoroscopic swallowing study findings of a consecutive series of 103 stroke patients were analysed. Items of the functional dysphagia scale were determined by the polychotomous linear logistic regression analysis between videofluoroscopic findings and aspiration. The sensitivity and specificity of the scale, and correlation between the total score of the scale and aspiration grade were measured. RESULTS: The final scale included the following eleven items; The score of lip closure, bolus formation, residue in oral cavity, oral transit time, triggering of pharyngeal swallow, laryngeal elevation and epiglottic closure, nasal penetration, residue in valleculae, coating of pharyngeal wall after swallow, pharyngeal transit time. The sensitivity and specificity of the scale for detecting supraglottic penetration and subglottic aspiration were 81.0%, 70.7% and 78.1%, 77.9% respectively. The total score of the scale was significantly correlated with the severity of aspiration. (Spermann correlation coefficient r=0.58943, p=0.00001). CONCLUSION: We developed functional dysphagia scale using videofluoroscopic swallowing study in stroke patients, which could be used as a simple, easy-to-use, quantifiable method to evaluate the severity of the dysphagia.