ESPEN 2012 - Late breaking abstract submission

Topic: Late Breaking Abstract

Abs n°:ESPEN12-1874

Abs Title: DIAGNOSTIC ACCURACY OF THE EATING ASSESSMENT TOOL AND THE VOLUME-VISCOSITY SWALLOW TEST FOR CLINICAL SCREENING AND ASSESSMENT OF OROPHARYNGEAL DYSPHAGIA

L. Rofes ^1,*V. Arreola ²R. Mukherjee ³P. Clavé ¹

¹CIBERehd - Hospital de Mataró, ²Hospital de Mataró, Mataró, Spain, ³Nestlé Research Center, Nestec Ltd, Lausanne, Switzerland

Rationale: Oropharyngeal dysphagia (OD) is a major contributor to malnutrition. We aimed to determine the diagnostic accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for OD.

Methods: We studied 120 patients with swallowing difficulties and 14 healthy persons. OD was clinically evaluated by a 10-item questionnaire (EAT-10) and a bedside method (V-VST). Scoring ≥3 in the EAT-10 is considered abnormal. The V-VST consisted of the administration of 5-20 mL liquid boluses at nectar (1.2g/100 mL water), thin (water) and extreme spoon-thick (6g/100 mL water) viscosities obtained with a xanthan gum based thickener (Resource®ThickenUpClear, Nestlé Health Science). The V-VST was considered positive for OD when one or more of the following signs were present: cough, fall in oxygen saturation ≥3%, voice changes (impaired safety); piecemeal deglutition or residue (impaired efficacy). Videofluoroscopy was the reference standard for OD diagnosis. Diagnostic accuracy was assessed by the AUC of the ROC curve and sensitivity and specificity values.

Results: Prevalence of OD was 94% and that of aspirations 19% according to the videofluoroscopic study. The EAT-10 showed a ROC AUC of 0.88 for OD and a sensitivity and specificity of 79% and 87% for EAT-10 ≥3. The V-VST presented 94% sensitivity and 87% specificity for OD, 86% sensitivity and 79% specificity for impaired safety, 91% sensitivity and 28% specificity for aspirations, and 78% sensitivity and 74% specificity for impaired efficacy.

Conclusion: Clinical methods for screening (EAT-10) and assessment (V-VST) of OD offer high diagnostic accuracy. We recommend their universal application to improve the nutritional management of older and neurological patients at risk for OD.

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Disclosure of Interest: L. Rofes: None DeclaredV. Arreola: None DeclaredR. Mukherjee: None DeclaredP. Clavé Grant/Research Support from: Nestec Ltd

Keywords: Dysphagiamalnutrition