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Moon, Sohn, Lee, Paek, Kang, Lee, Han, Lee, Kim, Park, and Yoo: Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2010; 40(3): 359-366.

Published online: 30 June 2010

DOI: https://doi.org/10.4040/jkan.2010.40.3.359

Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients

Kyung Hee Moon1, Hyun Sook Sohn2, Eun Seok Lee2, Eun Kyung Paek2, Eun Ju Kang2, Seung Hee Lee2, Na Ri Han2, Meen Hye Lee2, Deog Young Kim3, Chang Gi Park4, Ji-Soo Yoo5

1Director, Division of Nursing, Severance Hospital, Seoul, Korea.

2Registered Nurse, Department of Nursing, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

3Associate Professor, Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.

4Researcher, University of Illinois at Chicago, IL, USA.

5Professor, College of Nursing · Researcher, Nursing Policy Research Institute, Yonsei University, Seoul, Korea.

Address reprint requests to: Yoo, Ji-Soo. College of Nursing, Yonsei University, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-3252, Fax: 82-2-392-5440, yoojs48@yuhs.ac

Received 21 December 2009       Accepted 25 May 2010

Copyright © 2010 Korean Society of Nursing Science

Abstract

Purpose

The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool.

Methods

A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis.

Results

In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy.

Conclusion

The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

Keywords: Deglutition disorders, Risk assessment, Aspiration, Fluoroscopy

Figures and Tables

Figure 1
CART model of the dysphagia assessment tool.
1*=Abnormal; 2*=Normal; V49=Aspiration; V15=Cough during swallowing; V13=Oral stasis; V23=Facial symmetry; V31=Salivary drooling; V16=Cough after swallowing; CART=Classification and Regression Tree.
jkan-40-359-g001
Table 1
General Characteristics of Patients (N=202)
jkan-40-359-i001
Table 2
Diseases Related Characteristics of Patients (N=202)
jkan-40-359-i002

*Missing responses excluded.

Table 3
Characteristics Related to Videofluoroscopy (N=202)
jkan-40-359-i003

*Missing responses excluded.

Table 4
Revised Dysphagia Assessment Tool
jkan-40-359-i004
Table 5
Comparison of Risk Estimate Error of Aspiration in Revised Dysphagia Assessment Tool and Videofluoroscopy (N=202)
jkan-40-359-i005

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