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22. European Stroke Conference 17 Rehabilitation and reorganisation after stroke B 15:40 - 15:50 Prediction of longlasting dysphagia – the contribution of the Parramatta Hospitals’ As-sessment of Dysphagia G. Kägi1, N Leisi2, M Müller3, M Galovic4, B Weder5 Department of Neurology, Kantonsspital St.Gallen, St Gallen, SWITZERLAND1,Depart-ment of Otolaryngology, Logopaedia and Speech Therapy, Kantonsspital St.Gallen, St Gallen, SWITZERLAND2, Department of Otolaryngology, Logopaedia and Speech Therapy, Kantons-spital St.Gallen, St Gallen, SWITZERLAND3, Department of Neurology, Kantonsspital St.Gal-len, St Gallen, SWITZERLAND4, Department of Neurology, Kantonsspital St.Gallen, St Gal-len, SWITZERLAND5 Dysphagia is a common sequelae of stroke. More than 50 % of stroke patients show initially dysphagia, and in 20% it may persist for several months. In the long term there arises the ques-tion of PEG-tube application to ensure optimal nutrition. Guidelines recommend the insertion of a PEG-tube if dysphagia may last longer than 4 weeks but precise criteria for the indication of a PEG-tube are missing. Clinical assessment of dysphagia by the PHAD (Parramatta Hospitals‘ Assessment of Dyspha-gia) has been investigated with respect to its reliability in prediction of prolonged dysphagia and for a PEG-tube. It was hypothesized that the PHAD-score at day 8 to 10 after stroke shows significant correlation with the impairment of ingestion at 4 to 5 weeks. Patients with ischemic stroke and clinically diagnosed dysphagia were examined by an inde-pendent investigator, blinded to the other results, by the PHAD tool at two times (24 to 48h and 8 to10 days after stroke). Follow-up after 4 weeks included impairment of ingestion (BODS-2) and dysphagia-related QoL. (ADI-D). 266 patients were clinically assessed for dysphagia. 32 patients with prolonged dysphagia for more than 8 to10 days had their follow up examination after 4 to 5 weeks, 7 of them dependent on a PEG-tube. The Spearman’s rank-order correlation showed a significant correlation (rs= -0.589, p=0.001) between the PHAD-score at 8 to 10 days and the persisting impairment of in-gestion after 4 to 5 weeks. The analysis of the according regression lines showed a significant difference for the two dates of assessment (24 to 48h and 8 to 10 days) in predicting the BODS- 2-score after 4 to 5 weeks. The analysis of the ROC-curve substantiated the PHAD obtained at 8 to 10 days as a valuable tool for the prediction of prolonged dysphagia (AUC=0.971) and suggest a threshold of 70 (out of a total score of 100) to discriminate the longlasting severe courses. When considering a threshold around 70 of the total score 8 to 10 days after a stroke, the PHAD has a high prediction power for persisting dysphagia of 4 to 5 weeks . This approach of indication a PEG-tube is preserved for patients with supratentorial strokes 148 © 2013 S. Karger AG, Basel Scientific Programme


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