Usefulness of the volume-viscosity swallow test for screening dysphagia in subacute stroke patients in rehabilitation income

BACKGROUND: Swallowing disorders affect up to 35-85% of patients with stroke. Dysphagia complications can lead to malnutrition, dehydration, bronchoaspirative pneumonia and death, and have impact on health care costs. OBJECTIVE: To evaluate the clinical screening capacity of the Volume Viscosity Swallow Test (V-VST) for oropharyngeal dysphagia and aspiration in a homogeneous stroke patient sample. METHODS: Cohort study of 52 stroke patients in a subacute phase. Piecemeal deglutition and oropharyngeal residue were considered signs of impaired efficacy and cough, fall in oxygen saturation and voice changes, signs of impaired safety. Sensitivity, specificity, positive and negative predictive values, accuracy and likelihood ratios were calculated for V-VST results and compared with those of videofluoroscopy (VFS), the gold standard for studies on swallowing disorders. RESULTS: The V-VST is a highly sensitive and specific test to detect aspiration with sensitivity of 88.2% and specificity of 71.4%; negative predictive value was 92.6%; accuracy index was 0.74. Sensitivity and specificity for penetration were 34.3% and 70.6%, respectively; accuracy was 32%. CONCLUSIONS: The V-VST is low in cost, easy to use and very sensitive, meeting the requirements of oropharyngeal dysphagia and aspiration screening test in subacute stroke patients.