DePippo K L, Holas M A, Reding M J
Department of Speech/Language Pathology, Cornell University Medical College, Burke Rehabilitation Hospital, White Plains, NY.
Arch Phys Med Rehabil. 1994 Dec;75(12):1284-6.
The objective of this study was to validate a dysphagia screening test to identify patients in the rehabilitation phase post stroke at risk for pneumonia, recurrent upper airway obstruction, and death. The setting was an inpatient stroke rehabilitation unit. One hundred thirty-nine consecutive patients met the following criteria: stroke confirmed by clinical history and neurological exam with compatible computed tomography (CT) or magnetic resonance imaging (MRI) scan; ages 20 to 90 years inclusive; and no known history of significant oral or pharyngeal anomaly. The main outcome measures were pneumonia, recurrent upper airway obstruction, and death. The Burke Dysphagia Screening Test (BDST) identified 11 of 12 patients who subsequently developed pneumonia, recurrent upper airway obstruction, or death (Fisher's exact test: p = .03). The relative risk for the occurrence of any of these complications was 7.65 times greater for those failing versus passing the BDST. The BDST identified 9 of 9 patients who developed pneumonia (Fisher's exact test: p = .01). We concluded that the BDST is of value in identifying patients in the rehabilitation phase poststroke at risk for pneumonia, recurrent upper airway obstruction, and death.
本研究的目的是验证一项吞咽困难筛查测试，以识别处于中风后康复阶段、有肺炎、反复上呼吸道梗阻和死亡风险的患者。研究地点为住院中风康复病房。139名连续患者符合以下标准：经临床病史和神经检查确诊中风，且计算机断层扫描（CT）或磁共振成像（MRI）扫描结果相符；年龄在20至90岁之间；无明显口腔或咽部异常的已知病史。主要结局指标为肺炎、反复上呼吸道梗阻和死亡。伯克吞咽困难筛查测试（BDST）在随后发生肺炎、反复上呼吸道梗阻或死亡的12名患者中识别出11名（Fisher精确检验：p = 0.03）。未能通过BDST的患者发生这些并发症中任何一种的相对风险是通过测试患者的7.65倍。BDST在发生肺炎的9名患者中识别出9名（Fisher精确检验：p = 0.01）。我们得出结论，BDST在识别中风后康复阶段有肺炎、反复上呼吸道梗阻和死亡风险的患者方面具有价值。
