Comparison of two bedside evaluation methods of dysphagia in patients with acute stroke

BACKGROUND: Dysphagia is a common complication after stroke. Water swallowing test (WST) is a recognised but limited tool in providing details about dysphagia, including severity and how to adjust the diet based on the test results. METHODS: We performed a prospective observational study of comparing WST and volume–viscosity swallow test (V-VST) in patients with acute stroke within 14 days. All patients had WST and if failed would have a V-VST. The primary outcome was to compare the dysphagia levels assessed by these two test tools. The secondary outcome was to explore the predictive capability in patients who were at high risk of pneumonia by these two swallowing tests. RESULTS: Consecutively 276 patients with stroke were enrolled in our study, and 197 had normal WST. Among 79 patients who had both WST and V-VST, 20 showed swallowing safety and effectiveness by V-VST. The chance of being on tube feeding was strongly related to the positive results of failed WST (p<0.001). Both tests showed good predictive ability in patients with stroke for pneumonia even some of them were placed on tube feeding (p=0.001 in WST and p<0.001 in V-VST). CONCLUSIONS: V-VST performed better as a clinical screening test for dysphagia in patients with acute stroke at the bedside. TRIAL REGISTRATION NUMBER: ChiCTR1800016442.