Browsing by Subject "Volume-Viscosity Swallow Test"

Background. Dysphagia is one of the most common complications of stroke. Previous studies have shown that dysphagia is associated with malnutrition, fluid imbalance, difficulties in medical treatment, post-stroke pneumonia, higher mortality during the first three months post stoke, and longer periods of treatment with higher costs. Dysphagia screening plays a key role in the early detection of dysphagia and preventing these risks. Aims. The purpose of the study is to determine the reliability of the dysphagia screening practice in the Stroke-unit of the Helsinki University Hospital (HUH). The study compares the current nurse screening protocol (hoitajan seulontatutkimus, HST) to the validated Volume-Viscosity Swallow Test (V-VST) -screening tool. In addition, the study evaluates the effect of bolus volume and viscosity on swallowing, as well as the effect of patient related factors on the incidence and severity of dysphagia. Methods. The research material consisted of fiberoptic endoscopic evaluation of swallowing (FEES) studies performed on patients in the Stroke-unit during which both HST and V-VST screenings were performed. The recorded FEES studies were analyzed using the Penetration-Aspiration Scale (PAS) and the Pooling-score, after which the clinical results of the HST and V-VST screenings were compared with the estimated swallowing functions from the video. The effects of bolus volume and viscosity on swallowing were also examined from the videos. Patient background information was collected from the patient information system Uranus. Results and conclusions. The V-VST screening proved to be more reliable than HST, being both more sensitive and more specific. Both bolus volume and viscosity showed statistically significant connections to the PAS-values analyzed from the recorded FEES-studies. Bolus viscosity was also connected to the clinical signs of impaired safety of swallowing, including couching during or after the V-VST –screen and changes in the quality of voice. Of the selected background factors, only smoking was statistically significantly associated with the incidence and severity of dysphagia in the study population. The results of this study will be used to develop the dysphagia screening practice.