Abstract
Background
The evaluation of swallowing disorders and their rehabilitative modalities is an important topic. The benefit to the patient, in terms of improvement in quality of life, cannot be underestimated. Bedside tests might be used to identify patients with oropharyngeal dysphagia and to identify those who are at a risk for aspiration.
Aim
The aim of the present study was to evaluate the validity and reliability of the Gugging Swallowing Screening (GUSS) test for the detection of aspiration and swallowing abnormalities in dysphagic Egyptian patients. This helps in better management.
Study design
The present study was a comparative, cross-sectional study.
Patients and methods
A total of 42 patients were referred from the outpatient clinics with a complaint of dysphagia. All patients were evaluated using flexible endoscopic examination of swallowing (FEES) and the GUSS test. The results of these two methods were compared to assess validity. Reliability was approved by the assessment of the Cohen’s κ agreement between the two independent raters.
Results
The mean age of the patients was 51.6±12.2 years. According to the results of FEES, 28 (66.7%) patients were at a risk for aspiration, whereas 30 (71.4%) patients were rated to be at a risk according to the GUSS test results. According to the cutoff of 14 points, GUSS reached 93.3% sensitivity and 83.3% specificity when compared with FEES. Positive predictive value was 93.3% and negative predictive value was 83.3%. The results of reliability (by comparing the scores of the two raters as regards the degree of severity) showed excellent agreement between the two raters (κ=0.84, P>0.05, PO=91%).
Conclusion
GUSS test proved to be an easy, valid, and reliable test to predict the risk for aspiration among the adult Egyptian patients.
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References
Leder SB, Espinosa JF. Aspiration risk after acute stroke: comparison of clinical examination and fiberoptic endoscopic evaluation of swallowing. Dysphagia 2002; 17:214–218.
Park Y-H, Han H-R, Oh B-M, Lee J, Park J-a, Yu SJ, et al. Prevalence and associated factors of dysphagia in nursing home residents. Geriatr Nurs (Minneap) 2013; 34:212–217.
Wakasugi Y, Tohara H, Hattori F, Motohashi Y, Nakane A, Goto S, et al. Screening test for silent aspiration at the bedside. Dysphagia 2008; 23:364–370.
Alagiakrishnan K, Fisher C, Kurian M. Mealtime challenges and swallowing difficulties in elderly dementia patients. Chapter 108. In: Preedy CRMR, eds. Diet and nutrition in dementia and cognitive decline San Diego: Academic Press; 2015;1149–1158.
Hirano I, Kahrilas PJ. A 78-year-old man with difficulty swallowing. Clin Gastroenterol Hepatol 2011; 9:470–474.
Barnard SL. Nursing dysphagia screening for acute stroke patients in the emergency department. J Emerg Nurs 2011; 37:64–67.
Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, et al. Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen. Stroke 2007; 38:2948–2952.
Langmore SE, Schatz K, Olson N. Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol 1991; 100:678–681.
Shem KL, Castillo K, Wong SL, Chang J, Kao M-C, Kolakowsky-Hayner SA. Diagnostic accuracy of bedside swallow evaluation versus videofluoroscopy to assess dysphagia in individuals with tetraplegia. PM&R 2012; 4:283–289.
Martino R, Silver F, Teasell R, Bayley M, Nicholson G, Streiner DL, et al. The Toronto Bedside Swallowing Screening Test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke. Stroke 2009; 40:555–561.
Cichero JAY, Heaton S, Bassett L. Triaging dysphagia: nurse screening for dysphagia in an acute hospital. J Clin Nurs 2009; 18: 1649–1659.
Suiter DM, Leder SB. Clinical utility of the 3-ounce water swallow test. Dysphagia 2008; 23:244–250.
Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs 2009; 65:477–493.
Altman DG. Practical statistics for medical research. New York, NY Chapman & Hall/CRC Press 1999.
Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A Penetration-Aspiration Scale. Dysphagia 1996; 5:93–98.
Li L, Zhang L-h, Xu W-p, Hu J-m. Risk assessment of ischemic stroke associated pneumonia. World J Emerg Med 2014; 5:209–213.
Hassan HE, Aboloyoun AI. The value of bedside tests in dysphagia evaluation. Egypt J Ear Nose Throat Allied Sci 2014; 15:197–203.
DePippo KL, Holas MA, Reding MJ, Mandel FS, Lesser ML. Dysphagia therapy following stroke: a controlled trial. Neurology 1994; 44: 1655–1660.
Daniels SK, McAdam CP, Brailey K, Foundas AL. Clinical assessment of swallowing and prediction of dysphagia severity. Am J Speech-Language Pathol 1997; 617.
Hinds NP, Wiles CM. Assessment of swallowing and referral to speech and language therapists in acute stroke. QJM 1998; 91:829–835.
Logemann JA, Veis S, Colangelo LA. Screening procedure for oropharyngeal dysphagia. Dysphagia J 1999; 14:44–51.
Edmiaston J, Connor LT, Steger-May K, Ford AL. A simple bedside stroke dysphagia screen, validated against videofluoroscopy, detects dysphagia and aspiration with high sensitivity. J Stroke Cerebrovasc Dis 2013; 23:712–716.
Norton B, Homer-Ward M, Donnelly MT, Long RG, Holmes GK. A randomized prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ 1996; 312:13–16 63.
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AbdelHamid, A., Abo-Hasseba, A. Application of the GUSS test on adult Egyptian dysphagic patients. Egypt J Otolaryngol 33, 103–110 (2017). https://doi.org/10.4103/1012-5574.199419
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DOI: https://doi.org/10.4103/1012-5574.199419