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Barnes Jewish Hospital Stroke Dysphagia Screen

Calculators  Multiple body systems
This Barnes Jewish Hospital Stroke Dysphagia Screen is used to aid healthcare professionals in recognizing dysphagia in patients who have suffered a stroke.
No 0
Yes 1
Facial inequality/debility present
No 0
Yes 1
Tongue inequality/weakness present
No 0
Yes 1
Palatal inequality/weakness present
No 0
Yes 1
Any indications of aspiration during 3oz water test
No 0
Yes 10
Result:

Background

Measured Factor
dysphagia among stroke patients
Measured Factor Disease
  • dysphagia
  • increased risk of mortality
  • aspiration
Measured Factor Detail
Dysphagia among patients who have suffered a stroke is associated with increased risk of aspiration, which correlates to a significantly increased risk of mortality. It is important to prevent aspiration risks in patients who are allowed to swallow food after stroke. The sreen determines which stroke patients can safely tolerate a normal diet and which patients should be referred to speech pathology. Factors included in this screen are Glasgow Coma Scale, facial inequality/debility present , tongue inequality/weakness, palatal inequality/weakness, and aspiration during 3oz water test.
Speciality
Multi-Speciality
Body System
Multiple body systems
Measured Factor High Impact
  • If any of the 4 screening questions are "Yes", patients are at risk for aspiration and dysphagia
  • Do not perform water test

Result Interpretation

Ranges Ranges
  • Normal: an answer of "No" on all questions in the examination
  • Normal Adult Male: an answer of "No" on all questions in the examination
  • Normal Adult Female: an answer of "No" on all questions in the examination
  • Normal Geriatric Male: an answer of "No" on all questions in the examination
  • Normal Geriatric Female: an answer of "No" on all questions in the examination
Result High Conditions
  • dysphagia
  • increased risk of mortality
  • aspiration

Studies

Study Validation 1
This study examined the sensitivity and specificity of the Barnes-Jewish Hospital Stroke Dysphagia Screen (BJH-SDS) compared to the video-fluoroscopic swallow study (VFSS) which has been the gold standard test for dysphagia. Nurses performed the BJH-SDS after patients were admitted to the hospital for stroke, and then the patients underwent the VFSS performed by a speech pathologist. The study included 225 patients. The sensitivity of the BJH-SDS for dysphagia as measured by VFSS was 94%, and the specificity was 66%. Overall, the researchers determined that the BJH-SDS is an accurate tool that may be used for screening patients for dysphagia.
References: 2

Authors

Jeff Edmiaston
MS, Barnes-Jewish Hospital
https://www.researchgate.net/profile/Jeff_Edmiaston, speech language pathologist in the department of rehabilitation
Research Interests: https://www.linkedin.com/in/jeff-edmiaston-a8613a127/

References

  1. Edmiaston J, Connor LT, Loehr L, Nassief A. Validation of a dysphagia screening tool in acute stroke patients. Am J Crit Care. 2010 Jul;19(4):357-64.
  2. Edmiaston J, Connor LT, Steger-May K, Ford AL. A simple bedside stroke dysphagia screen, validated against videofluoroscopy, detects dysphagia and aspiration with high sensitivity. J Stroke Cerebrovasc Dis. 2014 Apr;23(4):712-6.