The portuguese version of the gugging swallowing screen
results from its application
Keywords:deglutition disorders, stroke, reproducibility of results
Introduction: Dysphagia is a frequent complication after a stroke which is associated with increased risk of pneumonia, dehydration and malnutrition. Early screening reduces the incidence of pneumonia after stroke.
Objective: To translate, cross cultural adapt and test the Portuguese version of the Gugging Swallowing Screen.
Methods: 226 acute stroke patients were prospectively enrolled in a multicentre study in stroke units. The Gugging Swallowing Screen was administered by nurses on patient’s admission. Results were compared to National Institute Health Stroke Scale and Glasgow Coma Scale scores and nurse’s clinical judgment. Inter-rater reliability was established.
Results: The incidence of dysphagia using GUSS was 47.3%. Sensitivity, specificity and the area under the receiver operating characteristic curve were, respectively, 85.4%, 84.6% and 0.892., using nurse’s clinical judgment as a reference. A significant association was established between positive screening and a higher neurological deficit (χ2=32.99; p<0.001) and no dysphagia with mild coma (χ2=15.15; p<0.001). Excellent inter-rater reliability (k=0.940) was reached.
Conclusion: The results suggest that the Portuguese version of the Gugging Swallowing Screen produces similar results as its original version, is simple to administer at bedside by nurses, is reliable and with adequate sensitivity to guide healthcare professionals in determining the need of a more comprehensive evaluation.
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