The predictive dysphagia score (PreDyScore) in the short- and medium-term post-stroke

a putative tool in PEG indication

on the behalf of the PreDyScore Group

Research output: Contribution to journalArticle

Abstract

Purpose: We performed an evaluation of dysphagia in an unselected series of strokes to identify factors causing persisting dysphagia at 1 month after onset and to formulate a predictive score. Methods: We evaluated the association between dysphagia and clinical aspects (univariate analysis) at the 7th and 30th days after admission. We performed a multivariate logistic regression at the 30th day on the factors that were significant. We computed a simple score for predicting persistent dysphagia. Results: We recruited 249 patients. At the 7th day, 94 patients were dysphagic (37.75%). Factors associated with dysphagia included TACI (OR 3.85), mRS ≥ 3 (OR 4.45), malnutrition (OR 2.69), and BMI ≥ 20 (OR 0.52). At the 30th day, 217 patients remained in the study, and dysphagia persisted in 75 (36.76%). The factors that were associated with dysphagia were age > 74 years (OR 1.99), TACI (OR 5.82), mRS score ≥ 3 (OR 4.31), malnutrition (OR 3.27), and BMI ≥ 20 (OR 0.45). The multivariate analysis indicated that mRS ≥ 3 (OR 1.80) and BMI ≥ 20 (OR 0.45) remained significantly associated with dysphagia. The best correlation with dysphagia was the sum of mRS and the reciprocal of the BMI multiplied by 100 ((mRS + 1 ∕ BMI) × 100). We named this score PreDyScore that ranged between 3.7 and 10.47. Using < 6 and > 8 as cutoffs, the sensitivity was 67.03%, and the specificity 95.65%. Conclusion: BMI < 20 and mRS ≥ 3 are easily measurable bedside predictive factors of persistent dysphagia. PreDyScore showed good sensitivity and very good specificity and enables the prediction of persistent dysphagia with great accuracy in any clinical setting.

Original languageEnglish
JournalNeurological Sciences
DOIs
Publication statusPublished - Jan 1 2019

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Deglutition Disorders
Stroke
Malnutrition
Multivariate Analysis
Logistic Models

Keywords

  • Aspiration pneumonia
  • BMI
  • Dysphagia
  • mRS
  • PEG
  • Stroke

ASJC Scopus subject areas

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

The predictive dysphagia score (PreDyScore) in the short- and medium-term post-stroke : a putative tool in PEG indication. / on the behalf of the PreDyScore Group.

In: Neurological Sciences, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Purpose: We performed an evaluation of dysphagia in an unselected series of strokes to identify factors causing persisting dysphagia at 1 month after onset and to formulate a predictive score. Methods: We evaluated the association between dysphagia and clinical aspects (univariate analysis) at the 7th and 30th days after admission. We performed a multivariate logistic regression at the 30th day on the factors that were significant. We computed a simple score for predicting persistent dysphagia. Results: We recruited 249 patients. At the 7th day, 94 patients were dysphagic (37.75{\%}). Factors associated with dysphagia included TACI (OR 3.85), mRS ≥ 3 (OR 4.45), malnutrition (OR 2.69), and BMI ≥ 20 (OR 0.52). At the 30th day, 217 patients remained in the study, and dysphagia persisted in 75 (36.76{\%}). The factors that were associated with dysphagia were age > 74 years (OR 1.99), TACI (OR 5.82), mRS score ≥ 3 (OR 4.31), malnutrition (OR 3.27), and BMI ≥ 20 (OR 0.45). The multivariate analysis indicated that mRS ≥ 3 (OR 1.80) and BMI ≥ 20 (OR 0.45) remained significantly associated with dysphagia. The best correlation with dysphagia was the sum of mRS and the reciprocal of the BMI multiplied by 100 ((mRS + 1 ∕ BMI) × 100). We named this score PreDyScore that ranged between 3.7 and 10.47. Using < 6 and > 8 as cutoffs, the sensitivity was 67.03{\%}, and the specificity 95.65{\%}. Conclusion: BMI < 20 and mRS ≥ 3 are easily measurable bedside predictive factors of persistent dysphagia. PreDyScore showed good sensitivity and very good specificity and enables the prediction of persistent dysphagia with great accuracy in any clinical setting.",
keywords = "Aspiration pneumonia, BMI, Dysphagia, mRS, PEG, Stroke",
author = "{on the behalf of the PreDyScore Group} and Carlo Gandolfo and Samir Sukkar and Ceravolo, {Maria Gabriella} and Fiorenzo Cortinovis and Cinzia Finocchi and Raffaella Gradaschi and Paolo Orlandoni and Nicoletta Reale and Stefano Ricci and Daniela Vassallo and Andrea Zini",
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AU - Gandolfo, Carlo

AU - Sukkar, Samir

AU - Ceravolo, Maria Gabriella

AU - Cortinovis, Fiorenzo

AU - Finocchi, Cinzia

AU - Gradaschi, Raffaella

AU - Orlandoni, Paolo

AU - Reale, Nicoletta

AU - Ricci, Stefano

AU - Vassallo, Daniela

AU - Zini, Andrea

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KW - PEG

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