Swallowing and Aspiration Risk: A Critical Review of Non Instrumental Bedside Screening Tests.
Swallowing and Aspiration Risk: A Critical Review of Non Instrumental Bedside Screening Tests.
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DOI：
10.3988/jcn.2018.14.3.265
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Milionis H
中科院分区：
文献类型：
--
作者：
Virvidaki IE;Nasios G;Kosmidou M;Giannopoulos S;Milionis H
卒中患者出现吞咽困难和误吸与死亡率和发病率增加有关。在日常临床实践中，通过可靠的微创床边手术在并发症出现之前早期识别和管理这两种疾病仍然具有挑战性。本研究通过定性观察参考人群研究设计、临床灵活性、可靠性和急性护理环境的适用性，回顾了用于检测急性卒中患者吞咽状态和误吸风险的现有床边筛查工具。主要检索使用PubMed、Embase和Cochrane图书馆数据库。搜索仅限于1991年至2016年期间发表的用英语撰写的关于人类的论文。入选标准包括连续入组急性卒中住院患者，并制定该人群口服喂养期间误吸风险筛查方案。在确定的652个来源中，完整审查了75篇文章，但只有12篇符合选择标准。大多数床边筛查方案的显著缺陷包括方法设计不佳和误吸风险预测值不足，这使得临床医生在提出饮食建议时更加保守。文献中有大量用于评估吞咽困难存在的筛查方法，但对急性卒中后误吸风险的预测价值较低。一种标准的、实用的、具有成本效益的筛查工具，可以在床边应用，并由广泛的医院人员解释，仍有待开发。在既没有训练有素的人员评估吞咽困难，也没有临床仪器程序的情况下，这一需求得到了强调。
The presence of dysphagia and aspiration in stroke patients is associated with increased mortality and morbidity. Early recognition and management of these two conditions via reliable, minimally invasive bedside procedures before complications arise remains challenging in everyday clinical practice. This study reviews the available bedside screening tools for detecting swallowing status and aspiration risk in acute stroke by qualitatively observing reference population study design, clinical flexibility, reliability and applicability to acute-care settings. The primary search was conducted using the PubMed, Embase, and Cochrane Library databases. The search was limited to papers on humans written in English and published from 1991 to 2016. Eligibility criteria included the consecutive enrollment of acute-stroke inpatients and the development of a protocol for screening aspiration risk during oral feeding in this population. Of the 652 sources identified, 75 articles were reviewed in full however, only 12 fulfilled the selection criteria. Notable deficiencies in most of the bedside screening protocols included poor methodological designs and inadequate predictive values for aspiration risk which render clinicians to be more conservative in making dietary recommendations. The literature is dense with screening methods for assessing the presence of dysphagia but with low predictive value for aspiration risk after acute stroke. A standard, practical, and cost-effective screening tool that can be applied at the bedside and interpreted by a wide range of hospital personnel remains to be developed. This need is highlighted in settings where neither trained personnel in evaluating dysphagia nor clinical instrumentation procedures are available.
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DOI：
10.1044/1092-4388(2005/089
发表时间：
2005-12-01
影响因子：
2.6
作者：
McCullough, GH;Rosenbek, JC;McCullough, K
通讯作者：
McCullough, K
影响因子：
2.6
作者：
Leder, Steven B.;Suiter, Debra M.;Green, Barry G.
通讯作者：
Green, Barry G.
影响因子：
1.7
作者：
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通讯作者：
Martino, Rosemary
影响因子：
8.3
作者：
Mann, G;Hankey, GJ;Cameron, D
通讯作者：
Cameron, D
影响因子：
9.9
作者：
Finlayson, O.;Kapral, M.;Saposnik, G.
通讯作者：
Saposnik, G.