Abstract:

Objective To explore the value of applying the water swallowing test to screening the aspiration and diagnosing dysphagia for patients with dysphagia after acute stroke. Methods Forty-five patients with acute stroke who were admitted by the Rehabilitation Medicine Department at the Gongli Hospital in Pudong New District of Shanghai from April 2014 to November 2015 were enrolled. Patients underwent the water swallowing test and videofluoroscopic swallowing study (VFSS). The reliability of the water swallowing test and the consistency between water swallowing test and VFSS for screening the aspiration and diagnosing dysphagia were evaluated. The positive detection rates of the water swallowing test for screening aspiration and diagnosing dysphagia were compared. Results The sensitivity, specificity, positive predictive value, and negative predictive value of the water swallowing test for screening aspiration against the VFSS were 43.75%, 69.23%, 77.78%, and 31.03%. The Kappa value of the consistency test for water swallowing test and VFSS was 0.098, indicating no consistency existed (P=0.420). The sensitivity, specificity, positive predictive value, and negative predictive value of the water swallowing test for diagnosing dysphagia against the VFSS study were 97.50%, 20.00%, 90.70%, and 50.00%. The Kappa value of the consistency test for water swallowing test and VFSS was 0.237, indicating no consistency existed (P=0.073). The positive detection rate (40.00%) of the water swallowing test for screening aspiration was lower than that for diagnosing dysphagia (95.56%) and the difference was statistically significant (P=0.000). Conclusion The water swallowing test may be unreliable for screening the aspiration for patients with dysphagia after acute stroke, but is relatively reliable for diagnosing dysphagia.

Key words: water swallowing test, videofluoroscopic swallowing study, stroke, dysphagia, aspiration