Flexible endoscopic evaluation of swallowing vs. screening tests for dysphagia and their effect on the final outcome in post-acute stroke patients

Authors: G. Solná 1;  D. Václavík 1,2;  O. Pavlík 1;  B. Gwardová 1;  L. Staníková 3;  P. Komínek 3,4
Authors‘ workplace: Vzdělávací a výzkumný institut Agel, o. p. s., Neurologické oddělení, Vítkovická nemocnice, a. s., Ostrava 1;  Katedra neurologie, LF OU, Ostrava 2;  Klinika otorinolaryngologie a chirurgie hlavy a krku FN Ostrava 3;  Katedra kraniofaciálních oborů, LF OU, Ostrava 4
Published in: Cesk Slov Neurol N 2020; 83/116(6): 614-620
Category: Original Paper
doi: 10.48095/cccsnn2020614


Aim: Dysphagia is a common and often severe stroke complication. Dysphagia screening is used to detect presence of dysphagia in post stroke patients in the Czech Republic. The Gugging Swallowing Screen (GUSS) is the most common method. Flexible Endoscopic Evaluation of Swallowing (FEES) is another objective method capable of detecting dysphagia. Aim of this study was to correlate results of GUSS and FEES and to evaluate the impact of FEES on functional outcomes in stroke patients.

Patients and methods: 100 patients with acute stroke were randomized in two groups, 50 patients were tested with GUSS and FEES, and 50 patients only with GUSS. Death, dysphagia severity, severity of neurological deficit, and disability status were followed up to 30 days.

Results: 47 men and 53 women (mean age 71.2 years) were included in the study. We did not find any significant difference in deaths, length of hospitalizations, dysphagia severity, and pneumonia incidence between both groups. Correlation coefficient between GUSS and FEES screening was 0.8. In the FEES group, we adjusted the diet according to the FEES results in 20% of patients; in this group we found significantly lower respiratory infection incidence (P = 0.045).

Conclusion: Testing patients with FEES did not lead to better functional outcome after stroke in our patients. We lowered respiration infection incidence by adjusting the diet according to the FEES results.


dysphagia – screening – The Gugging Swallowing Screen – flexible endoscopic evaluation


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