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Reduced Incidence of Aspiration With Spoon-Thick Consistency in Stroke PatientsFrom Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. Correspondence: Address correspondence to: Patricia B. Diniz, 218, Comendador Albino cunha street, Porto Alegre, Brazil, 91040-040; e-mail: claudia.cp{at}terra.com.br
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.
Key Words: dysphagia • swallowing disorders • deglutition disorders • viscosity • respiratory aspiration • laryngoscopy • stroke
Nutrition in Clinical Practice, Vol. 24, No. 3,
414-418 (2009) |
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