Does a 3-Sip Test Detect Dysphagia in Acute Stroke Rehabilitation Patients?

Objectives (1) Evaluate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a 3-sip test within 24 hours of acute stroke as a screening for clinically relevant dysphagia during acute rehabilitation. (2) For those patients who pass the 3-sip test, identif...

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Bibliographic Details
Published in:PM & R 2010-09, Vol.2 (9), p.822-828
Main Authors: Kopey, Stephanie A., DO, Chae, John, MD, Vargo, Mary M., MD
Format: Article
Language:English
Subjects:
Aged
Deglutition Disorders - diagnosis
Deglutition Disorders - etiology
Female
Humans
Male
Middle Aged
Physical Medicine and Rehabilitation
ROC Curve
Sensitivity and Specificity
Stroke Rehabilitation
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Summary:Objectives (1) Evaluate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a 3-sip test within 24 hours of acute stroke as a screening for clinically relevant dysphagia during acute rehabilitation. (2) For those patients who pass the 3-sip test, identify factors predictive of later detection of clinically relevant dysphagia. Design A retrospective review. Setting Acute stroke rehabilitation unit of a tertiary academic medical center. Patients 223 patients undergoing dysphagia screening after stroke. Main Outcome Measure Development of clinically relevant dysphagia. Results Seventeen of 223 patients (7.6%) failed the 3-sip test. Of the 206 patients who passed the 3-sip test, 57 (27.7%) manifested clinically relevant dysphagia. Sensitivity and specificity of the 3-sip test were 20.8% and 98.7%, respectively. PPV and NPV were 88.2% and 72.3%, respectively. Among those who passed the 3-sip test, logistic regression identified the Functional Independence Measure (FIM) total score as the only independent predictor (B = −0.066, P < .001) of clinically relevant dysphagia. Of those patients who passed the 3-sip test, 54.6% with an FIM total score 60. Conclusions The sensitivity of the 3-sip test was poor for stroke rehabilitation patients. For those who passed the 3-sip test, a low FIM total score was predictive of development of clinically relevant dysphagia. A high degree of clinical suspicion for dysphagia should remain after passing a 3-sip screening test, especially for those with FIM total score
ISSN:1934-1482
1934-1563
DOI:10.1016/j.pmrj.2010.05.015