Department of Rehabilitation Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Department of Rehabilitation Medicine, On Hospital, Busan, Republic of Korea.
Int J Nurs Stud. 2020 Jul;107:103588. doi: 10.1016/j.ijnurstu.2020.103588. Epub 2020 Apr 18.
Dysphagia in patients with stroke can cause serious complications, such as aspiration and pneumonia, that often lead to increase in mortality and length of hospitalization. Several screening tests for dysphagia have been developed and are used in clinical practice to prevent dysphagia complications. The Gugging Swallowing Screen is 1 such screening test. It is suggested for use in the assessment of the ability of patients to swallow fluid and non-fluid foods separately. It also promotes effective communication between healthcare providers.
We aimed to investigate the validity and benefit of the Gugging Swallowing Screen.
This was a systematic review.
We sourced data from electronic databases including Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, KoreaMed, Research Information Sharing Service, and Korean studies Information Service System.
We conducted a systematic review of electronic databases. We included studies published in English and Korean up to November 2018 that pertained to the Gugging Swallowing Screen. We designed strategies that included Medical Subject Headings and keywords, such as "dysphagia," "swallowing," "assessment," "screening," and "GUSS," used alone or in combination.
Of the 297 studies that appeared in the search result, 219 articles were reviewed by 2 independent reviewers after duplicate studies were eliminated. Finally, 8 articles were included in this study. With regard to validity, the Gugging Swallowing Screen had a pooled sensitivity of 0.97 (95% confidence interval: 0.93-0.99), a pooled specificity of 0.67 (95% confidence interval: 0.59-0.74), and an area under the receiver operating characteristic curve of 0.9381. With regard to benefit, early systematic dysphagia screening using Gugging Swallowing Screen performed by nurses reduced both screening time and pneumonia rate compared to the control group (p = 0.004). The incidence of X-ray-verified pneumonia was significantly lower in the Gugging Swallowing Screen group than in the clinical screening group (p ˂ 0.01), but no significant difference was observed in the incidence of pneumonia compared to the value predicted using the 10 mL water swallowing test.
The Gugging Swallowing Screen is a reliable and sensitive tool for screening dysphagia. Early and systematic assessment can prevent aspiration and pneumonia. However, further studies are needed to confirm the effectiveness of this tool.
脑卒中患者的吞咽障碍可导致严重并发症，如吸入和肺炎，这通常会导致死亡率和住院时间增加。已经开发出几种吞咽障碍筛查测试，并在临床实践中用于预防吞咽障碍并发症。Gugging 吞咽筛查就是这样一种筛查测试。它建议用于评估患者分别吞咽液体和非液体食物的能力。它还促进了医疗保健提供者之间的有效沟通。
我们旨在研究 Gugging 吞咽筛查的有效性和益处。
这是一项系统评价。
我们从电子数据库中获取数据，包括 Ovid MEDLINE、Ovid EMBASE、Cochrane 图书馆、韩国医学数据库、研究信息共享服务和韩国研究信息系统。
我们对电子数据库进行了系统评价。我们纳入了截至 2018 年 11 月发表的英文和韩文研究，这些研究涉及 Gugging 吞咽筛查。我们设计了策略，包括使用单独或组合的 MeSH 主题词和关键词，如“吞咽障碍”、“吞咽”、“评估”、“筛查”和“GUSS”。
在搜索结果中出现的 297 篇研究中，2 位独立审查员审查了 219 篇重复的文章。最终，有 8 篇文章纳入本研究。关于有效性，Gugging 吞咽筛查的合并敏感性为 0.97（95%置信区间：0.93-0.99），合并特异性为 0.67（95%置信区间：0.59-0.74），受试者工作特征曲线下面积为 0.9381。关于益处，护士使用 Gugging 吞咽筛查进行早期系统吞咽障碍筛查，与对照组相比，可缩短筛查时间并降低肺炎发生率（p = 0.004）。Gugging 吞咽筛查组 X 线证实的肺炎发生率明显低于临床筛查组（p ˂ 0.01），但与 10 ml 水吞咽试验预测的肺炎发生率相比无显著差异。
Gugging 吞咽筛查是一种可靠和敏感的吞咽障碍筛查工具。早期和系统的评估可以预防吸入和肺炎。然而，需要进一步的研究来证实该工具的有效性。
