Despite medical advances, half of the patients admitted to hospital for recovery from acute illness, injury or surgery have swallowing difficulties and those requiring tubes for breathing support are at even greater risk. Difficulties with swallowing decrease patients' quality of life, prolong their hospital stay, as well as lead to medical complications such as pneumonia, malnutrition and death. Presently, there is no screening test for swallowing difficulties in patients who have required respiratory support. Screening will allow for early detection of swallowing problems which is important to prevent serious complications, such as pneumonia. This research will determine the accuracy of a new screening test, the Toronto Bedside Swallowing Screening Test (TOR-BSST©) previously tested with stroke patients, to predict the presence of swallowing difficulties in patients who have required breathing support for longer than 48 hours. The investigators will enroll 100 patients from the intensive care medical surgical units at the University Health Network. The findings from this research will help identify those patients with swallowing problems earlier than it is currently possible. Once identified, at risk patients will be referred to a speech language pathologist swallowing expert for more comprehensive testing; thereby, decreasing their risk of experiencing serious complications, such as pneumonia, secondary to swallowing problems.
Study Type
OBSERVATIONAL
Enrollment
100
All enrolled patients will be screened for dysphagia by two blinded screeners using the TOR-BSST©.
All enrolled patients will undergo a videofluoroscopic assessment of swallowing within 24 hours of being screened with the TOR-BSST©.
University Health Network
Toronto, Ontario, Canada
Validity of the TOR-BSST©
The validity of the TOR-BSST© will be measured using sensitivity, specificity, likelihood ratios, positive predictive value (PPV), and negative predictive value (NPV). Results of the videofluoroscopic assessment of swallowing will be used as the gold standard comparison.
Time frame: 24 hours
Inter-rater reliability of the TOR-BSST©
Inter-rater reliability will be calculated using the intraclass correlation coefficient (ICC).
Time frame: 24 hours
Estimation of the incidence of dysphagia in adult acute patients following prolonged intubation
Time frame: 24 hours
Description of the impairment characteristics of dysphagia in adult acute patients following prolonged intubation
Time frame: 24 hours
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