Development of a Dysphagia Screening Test for Preterm Infants (DST-PI).
10.5535/arm.2017.41.3.434
- Author:
Kyoung Moo LEE
1
;
Young Tak SEO
Author Information
1. Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. tak_sama@hanmail.net
- Publication Type:Original Article
- Keywords:
Dysphagia;
Premature infant;
Screening test;
Videofluoroscopic swallowing study;
Aspiration
- MeSH:
Cyanosis;
Deglutition;
Deglutition Disorders*;
Diagnosis;
Humans;
Infant;
Infant, Newborn;
Infant, Premature*;
Logistic Models;
Mass Screening*;
Oxygen;
ROC Curve;
Sensitivity and Specificity
- From:Annals of Rehabilitation Medicine
2017;41(3):434-440
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To explore both the early prediction and diagnosis of dysphagia in preterm infants as an important developmental aspect as well as the prevention of respiratory complications, we developed the simple and-easy-to-apply Dysphagia Screening Test for Preterm Infants (DST-PI) to predict supraglottic penetration and subglottic aspiration. METHODS: Fifty-two infants were enrolled in a videofluoroscopic swallowing study (VFSS) due to clinical suspicions of dysphagia. Thirteen items related to supraglottic penetration or subglottic aspiration were initially selected from previous studies for the DST-PI. Finally, 7 items were determined by linear logistic regression analysis. Cutoff values, sensitivity, specificity, and the area under the ROC curve (AUC) of the DST-PI for predicting supraglottic penetration or subglottic aspiration were calculated using a ROC curve. For inter-rater reliability, the kappa coefficient was calculated. RESULTS: Seven items were selected: ‘gestational age,’‘history of apnea,’‘history of cyanosis during feeding,’‘swallowing pattern,’‘coughs during or after feeding,’‘decreased oxygen saturation within 3 minutes of feeding,’ and ‘voice change after feeding.’ The Spearman correlation coefficient between the DST-PI and the penetration-aspiration scale (PAS) was 0.807 (p<0.001). The sensitivity and specificity at different cutoff values for detecting supraglottic penetration and subglottic aspiration were 96.6% and 76.9% at 3.25, and 88.9% and 75.8% at 6.25, respectively. CONCLUSION: The DST-PI is a valid and reliable dysphagia screening test for supraglottic penetration or subglottic aspiration in preterm infants that is easy to apply in a clinical context.
