TY - JOUR
T1 - Predicting prolonged dysphagia in acute stroke
T2 - The Royal Adelaide Prognostic Index for Dysphagic Stroke (RAPIDS)
AU - Broadley, Simon
AU - Cheek, Alison
AU - Salonikis, Susie
AU - Whitham, Emma
AU - Chong, Victoria
AU - Cardone, David
AU - Alexander, Basile
AU - Taylor, James
AU - Thompson, Philip
PY - 2005/10
Y1 - 2005/10
N2 - Dysphagia is common after stroke and is associated with increased morbidity and mortality. Predicting those who are likely to have significant prolonged dysphagia is not possible at present. This study was undertaken to validate the Royal Adelaide Prognostic Index for Dysphagic Stroke (RAPIDS) in the prediction of prolonged dysphagia following acute stroke using clinical and radiographic features. A prospective study of unselected, consecutive admissions to the Royal Adelaide Hospital acute stroke unit was undertaken. Clinical and radiographic features applicable to the RAPIDS test were calculated and the sensitivity, specificity, and likelihood ratio for predicting prolonged dysphagia were calculated with 95% confidence intervals (CI). Of 104 subjects admitted with acute stroke, 55 (53%) had dysphagia and 20 (19%) had dysphagia requiring nonoral feeding/hydration for 14 days or more or died while dysphagic prior to 14 days. The RAPIDS test had sensitivity of 90% (95% CI = 70-97%) and specificity of 92% (95% CI - 84-96%) for predicting this latter group of patients. We conclude that the RAPIDS test can be used early to identify patients likely to have prolonged dysphagia. This test could form a basis for selection of patients for trials of nonoral feeding methods.
AB - Dysphagia is common after stroke and is associated with increased morbidity and mortality. Predicting those who are likely to have significant prolonged dysphagia is not possible at present. This study was undertaken to validate the Royal Adelaide Prognostic Index for Dysphagic Stroke (RAPIDS) in the prediction of prolonged dysphagia following acute stroke using clinical and radiographic features. A prospective study of unselected, consecutive admissions to the Royal Adelaide Hospital acute stroke unit was undertaken. Clinical and radiographic features applicable to the RAPIDS test were calculated and the sensitivity, specificity, and likelihood ratio for predicting prolonged dysphagia were calculated with 95% confidence intervals (CI). Of 104 subjects admitted with acute stroke, 55 (53%) had dysphagia and 20 (19%) had dysphagia requiring nonoral feeding/hydration for 14 days or more or died while dysphagic prior to 14 days. The RAPIDS test had sensitivity of 90% (95% CI = 70-97%) and specificity of 92% (95% CI - 84-96%) for predicting this latter group of patients. We conclude that the RAPIDS test can be used early to identify patients likely to have prolonged dysphagia. This test could form a basis for selection of patients for trials of nonoral feeding methods.
KW - Cerebrovascular accident
KW - Deglutition
KW - Deglutition disorders
KW - Epidemiology
KW - Pneumonia, aspiration
KW - Predictors
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=33646397575&partnerID=8YFLogxK
U2 - 10.1007/s00455-005-0032-y
DO - 10.1007/s00455-005-0032-y
M3 - Article
C2 - 16633876
AN - SCOPUS:33646397575
VL - 20
SP - 303
EP - 310
JO - Dysphagia
JF - Dysphagia
SN - 0179-051X
IS - 4
ER -