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- Title
A Targeted Swallow Screen for the Detection of Postoperative Dysphagia.
- Authors
GEE, ERICA; LANCASTER, ELIZABETH; MELTZER, JOSPEH; MENDELSOHN, ABIE H.; BENHARASH, PEYMAN
- Abstract
Postoperative dysphagia leads to aspiration pneumonia, prolonged hospital stay, and is associated with increased mortality. A simple and sensitive screening test to identify patients requiring objective dysphagia evaluation is presently lacking. In this study, we evaluated the efficacy of a novel targeted swallow screen evaluation. This was a prospective trial involving all adult patients who underwent elective cardiac surgery with cardiopulmonary bypass at our institution over an 8-week period. Within 24 hours of extubation and before the initiation of oral intake, all postsurgical patients were evaluated using the targeted swallow screen. A fiberoptic endoscopic evaluation of swallowing was requested for failed screenings. During the study, 50 postcardiac surgery patients were screened. Fifteen (30%) failed the targeted swallow screen, and ten of the fifteen (66%) failed the subsequent fiberoptic endoscopic evaluation of swallowing exam and were confirmed to have dysphagia. The screening test had 100 per cent sensitivity for detecting dysphagia in our patient population, and a specificity of 87.5 per cent. The overall incidence of dysphagia was 20 per cent. We have shown that a targeted swallow evaluation can efficiently screen patients during the postcardiac surgery period. Furthermore, we have shown that the true incidence of dysphagia after cardiac surgery is significantly higher than previously recognized in literature.
- Subjects
CALIFORNIA; ASPIRATION pneumonia; CLINICAL trials; DEGLUTITION; DEGLUTITION disorders; FISHER exact test; CARDIAC surgery; LENGTH of stay in hospitals; LONGITUDINAL method; PROBABILITY theory; PROGNOSIS; RISK assessment; SURGICAL complications; SURVIVAL; T-test (Statistics); MATHEMATICAL variables; DISEASE incidence; DATA analysis software; GLASGOW Coma Scale; DISEASE complications; DIAGNOSIS
- Publication
American Surgeon, 2015, Vol 81, Issue 10, p979
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481508101014