Category: Stroke; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
To determine the degree of association between area of pharyngeal residue and swallow screen and ordinal pharyngeal residue rating, as well as the extent to which these measures drive therapy recommendations.
Design : Survey of treatment recommendations and videofluoroscopic swallow studies. Videofluoroscopy was conducted within 72 hours of diagnostic neuroimaging and initial swallow screen. Therapy recommendation was extracted from the evaluating clinician’s report.
Setting : Neurological critical care units
Participants (or Animals, Specimens, Cadavers) :
Convenience sample of 68 adult patients with diagnosis of stroke
Interventions : Not applicable
Main Outcome Measure(s) : Outcome measures of interest included Modified Barium Swallow Impairment Profile Pharyngeal Residue score and Normalized Residue Ratio Scale for vallecular and pyriform sinus residue. Residue measures were compared by Spearman’s correlations, and logistic regression modeling was conducted to determine the association between swallowing therapy recommendation (recommended/not recommended) and each measure of pharyngeal residue.
Results : All residue measures were moderately to strongly correlated (r=0.53-.0.87, p
Conclusions : The 4 point Modified Barium Impairment Profile Pharyngeal Residue score is reflective of 2D areas of vallecular and pyriform sinus residue; however, the lack of significant association with treatment recommendations suggests that clinicians are not using this information to inform which patients are recommended for treatment.