For a study, researchers sought to compare the accuracy of their BSSD to fiberoptic endoscopic evaluation of swallowing (FEES) in critically sick patients who had been extubated. After extubation, a bedside screening tool for swallowing dysfunction (SD) (BSSD) would be helpful in identifying patients at risk for SD. They performed a 1-year prospective monocentric research to compare the precision of our BSSD and FEES in diagnosing SD after endotracheal intubation (gold standard). They considered patients who had been intubated for more than 48 hours. Within 24 hours of extubation, both tests were evaluated. The accuracy of the BSSD was the primary endpoint. A secondary goal was to evaluate SD risk variables. In the study, 79 patients were involved. An SD was observed in 33 cases, or 42% of the total. The BSSD demonstrated 88% (95% CI 0.72-0.97) sensitivity and 91% (95% CI 0.79-0.98) specificity, as well as 88% (95% CI 0.72-0.97) positive predictive value and 91% (95% CI 0.79-0.97) negative predictive value. AUC equals to 0.83 (95% CI=0.74–0.92). The study described a reliable clinical screening technique for identifying SD in critically ill patients following extubation. Instrumental tests, ideally employing FEES, should be used to confirm instances that were positive during screening.
Source: sciencedirect.com/science/article/abs/pii/S0883944122001484
