비디오 투시 연하 검사에 근거한 Gugging Swallowing Screen의 타당도 평가
Validation of Gugging Swallowing Screen for Patients with Stroke Based on Videofluoroscopic Swallowing Study
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참고문헌
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초록
Objective: To evaluate the clinical validity of gugging swallowing screen (GUSS) scale in comparison with the findings of videofluoroscopic swallowing study (VFSS) for subacute and chronic stroke patients, though GUSS was developed in order to screen dysphagia in acute stroke patients. Method: The subjects of this study were thirty-five patients who had stroke for more than 3 months and were showing the symptom of dysphagia. GUSS, VFSS and clinical examination were performed respectively by three different physiatrists. These tests were performed at intervals of 24 hours or less. The result of GUSS was compared with videofluoroscopic dysphagia scale (VDS) based on VFSS, Clinical dysphagia scale (CDS), and ASHA scale based on clinical patterns. Results: The result of GUSS was in a significant correlation with VDS, CDS, and ASHA scale (p＜0.01). GUSS predicted aspiration very efficiently (area under the curve=0.928; 95% CI, 0.833 to 1.022). The cutoff value of 12 point showed sensitivity of 89.5%, specificity of 87.5%, and negative predictability of 87.5%. Conclusion: The GUSS is considered as an effective and convenient screening tool to evaluate stroke patients with dysphagia irrespective of stroke stages.
Abstract
Objective: To evaluate the clinical validity of gugging swallowing screen (GUSS) scale in comparison with the findings of videofluoroscopic swallowing study (VFSS) for subacute and chronic stroke patients, though GUSS was developed in order to screen dysphagia in acute stroke patients. Method: The subjects of this study were thirty-five patients who had stroke for more than 3 months and were showing the symptom of dysphagia. GUSS, VFSS and clinical examination were performed respectively by three different physiatrists. These tests were performed at intervals of 24 hours or less. The result of GUSS was compared with videofluoroscopic dysphagia scale (VDS) based on VFSS, Clinical dysphagia scale (CDS), and ASHA scale based on clinical patterns. Results: The result of GUSS was in a significant correlation with VDS, CDS, and ASHA scale (p＜0.01). GUSS predicted aspiration very efficiently (area under the curve=0.928; 95% CI, 0.833 to 1.022). The cutoff value of 12 point showed sensitivity of 89.5%, specificity of 87.5%, and negative predictability of 87.5%. Conclusion: The GUSS is considered as an effective and convenient screening tool to evaluate stroke patients with dysphagia irrespective of stroke stages.
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