PMID- 35676540
OWN - NLM
STAT- MEDLINE
DCOM- 20230126
LR  - 20230325
IS  - 1432-0460 (Electronic)
IS  - 0179-051X (Linking)
VI  - 38
IP  - 1
DP  - 2023 Feb
TI  - Predicting Failure to Recover Swallowing in Patients with Severe Post-stroke 
      Dysphagia: The DIsPHAGIc Score.
PG  - 290-304
LID - 10.1007/s00455-022-10467-9 [doi]
AB  - In post-stroke dysphagia, early identification of patients at highest risk of 
      failing swallowing recovery (SR) would be useful to decide which of them should 
      undergo percutaneous endoscopic gastrostomy. The studies on this subject were 
      numerous but generally based on small statistical samples. In this retrospective 
      study, 1232 patients with ischemic or hemorrhagic stroke (73.7 +/- 13.0 years, 51% 
      men) were assessed: 593 non-dysphagic, 351 partially dysphagic and 288 totally 
      dysphagic. Among the latter, 45.1% could not recover oral intake. A score to 
      assess the risk of failing SR was obtained from the group with total dysphagia, 
      and further 210 patients with total post-stroke dysphagia were utilized for 
      validation. A regular progression of stroke severity markers, complications and 
      mortality was observed from non-dysphagic, to partially dysphagic, up to totally 
      dysphagic patients. Among the latter, seven variables were independently 
      associated with failure of SR, and formed the "DIsPHAGIc score": cerebral lesion 
      Diameter >/= 6 cm (+ 1), left frontal Ischemia (- 1), Partial anterior circulation 
      syndrome (- 1), Hypoxia (+ 1), Antiplatelet drug (+ 1), GCS verbal reaction < 4 
      (+ 1), Internal capsule ischemia (- 1). The area under the ROC curve was 0.79 
      (95% CI 0.74-0.85). For total scores >/= 2 there was a high risk of failing SR, 
      with specificity 76.9%, sensitivity 72.1% and accuracy 74.7%. The application of 
      the DIsPHAGIc score to the validation sample provided almost identical results. 
      The evolution of post-stroke dysphagia towards irreversibility can be predicted 
      by a simple, reproducible and robust scoring system based on 7 variables commonly 
      available during hospitalization.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Muscari, Antonio
AU  - Muscari A
AUID- ORCID: 0000-0003-4943-4793
AD  - Stroke Unit-Medical Department of Continuity of Care and Disability, IRCCS 
      Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 
      antonio.muscari@unibo.it.
AD  - Department of Medical and Surgical Sciences, University of Bologna, Via 
      Massarenti, 9, 40138, Bologna, Italy. antonio.muscari@unibo.it.
FAU - Falcone, Roberta
AU  - Falcone R
AD  - Department of Medical and Surgical Sciences, University of Bologna, Via 
      Massarenti, 9, 40138, Bologna, Italy.
FAU - Pirazzoli, Enrico
AU  - Pirazzoli E
AD  - Department of Medical and Surgical Sciences, University of Bologna, Via 
      Massarenti, 9, 40138, Bologna, Italy.
FAU - Faccioli, Luca
AU  - Faccioli L
AD  - Diagnostic and Interventional Neuroradiology Unit, IRCCS Azienda 
      Ospedaliero-Universitaria di Bologna, Bologna, Italy.
FAU - Muscari, Silvia
AU  - Muscari S
AD  - Department of Rehabilitation, ASST Pini-CTO Hospital, Milan, Italy.
FAU - Pastore Trossello, Marco
AU  - Pastore Trossello M
AD  - Diagnostic and Interventional Neuroradiology Unit, IRCCS Azienda 
      Ospedaliero-Universitaria di Bologna, Bologna, Italy.
FAU - Puddu, Giovanni M
AU  - Puddu GM
AD  - Stroke Unit-Medical Department of Continuity of Care and Disability, IRCCS 
      Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
FAU - Rignanese, Loredana
AU  - Rignanese L
AD  - Stroke Unit-Medical Department of Continuity of Care and Disability, IRCCS 
      Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
AD  - Physical Medicine and Rehabilitation Unit, IRCCS Azienda 
      Ospedaliero-Universitaria di Bologna, Bologna, Italy.
FAU - Spinardi, Luca
AU  - Spinardi L
AD  - Diagnostic and Interventional Neuroradiology Unit, IRCCS Azienda 
      Ospedaliero-Universitaria di Bologna, Bologna, Italy.
FAU - Zoli, Marco
AU  - Zoli M
AD  - Stroke Unit-Medical Department of Continuity of Care and Disability, IRCCS 
      Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
AD  - Department of Medical and Surgical Sciences, University of Bologna, Via 
      Massarenti, 9, 40138, Bologna, Italy.
LA  - eng
PT  - Journal Article
DEP - 20220609
PL  - United States
TA  - Dysphagia
JT  - Dysphagia
JID - 8610856
SB  - IM
MH  - Male
MH  - Humans
MH  - Female
MH  - *Deglutition Disorders/etiology/complications
MH  - Deglutition
MH  - Retrospective Studies
MH  - Gastrostomy/methods
MH  - *Stroke/complications
OTO - NOTNLM
OT  - Dysphagia
OT  - PEG
OT  - Risk factors
OT  - Score
OT  - Stroke
OT  - Validation
EDAT- 2022/06/09 06:00
MHDA- 2023/01/27 06:00
CRDT- 2022/06/08 23:33
PHST- 2021/10/16 00:00 [received]
PHST- 2022/05/16 00:00 [accepted]
PHST- 2022/06/09 06:00 [pubmed]
PHST- 2023/01/27 06:00 [medline]
PHST- 2022/06/08 23:33 [entrez]
AID - 10.1007/s00455-022-10467-9 [pii]
AID - 10.1007/s00455-022-10467-9 [doi]
PST - ppublish
SO  - Dysphagia. 2023 Feb;38(1):290-304. doi: 10.1007/s00455-022-10467-9. Epub 2022 Jun 
      9.