STATE OF THE ART IN ASPIRATION ASSESSMENT AND THE IDEA OF A NEW NON INVASIVE PREDICTIVE TEST FOR THE RISK OF ASPIRATION IN STROKE

Background: Dysphagia is a common but severe complication in acute stroke. New bedside tests are necessary to assess the risk of aspiration and avoid unnecessary alimentary restrictions but they must be completed by evaluated instruments. Objective: We evaluated the prognostic validity of the recognition of forms (rf) test related to the assessment by speech and language therapists (SLT). Design: Double blinded screening tests. Setting: Geriatric department of general hospital. Subjects: 50 patients with acute stroke admitted consecutively. Methods: All patients were assessed by SLT, mini mental status test, short test for assessing deficits of memory and attention and abilities of daily living-test. The rf-test was performed twice with a twoweek interval. Results: Assessment by SLT demonstrated aspiration in 29 of 50 patients. 18 patients failed the rftest, giving a specificity of 90% (positive predictive value 89%), a sensitivity of 55% (negative predictive value 59%). 5 of 7 patients with aspiration pneumonia failed the test. Test-retest-correlation was 0,827. Performance in the rf-test was related significantly to results of the activities of daily living-test. Conclusions: Bedside tests to exclude aspiration in patients with acute stroke are necessary. No test so far combines high sensitivity with acceptable specificity. Compared to other bedside tests the rf-test has a high specificity while sensitivity is low. On behalf of good predictivity rf-test may be an interesting supplement to swallow tests in case of stroke and seems to be a candidate for more extended studies