A Tough Pill to Swallow: Bedside Dysphagia Screening in Geriatric Trauma Patients.

INTRODUCTION

We hypothesized that Bedside screening tests (BSTs) would identify dysphagia in geriatric trauma patients without overt swallowing difficulties.

METHODS

Trauma patients ≥65 y were eligible for enrollment. Patients with known risk factors for dysphagia were excluded. All patients underwent BST by nursing and speech and language pathologist followed by a diagnostic confirmatory test for dysphagia. The primary outcomes were diagnostic test characteristics for BST.

RESULTS

Of 139 enrolled patients, 29 (21%) had dysphagia. Median age was 78 y (interquartile range: 72-85). Nursing BST had a sensitivity of 0.12, specificity of 0.96, positive predictive value of 0.43, a negative predictive value of 0.81, and an accuracy of 0.79. Speech and language pathologist BST had a sensitivity of 0.38, specificity of 0.76, positive predictive value of 0.30, a negative predictive value of 0.82, and an accuracy of 0.68.

CONCLUSIONS

Dysphagia was present in 21% of a geriatric trauma population without overt swallowing difficulties, and BSTs had sufficient specificity for screening but poor sensitivity.