Swallowing assessment in primary brain tumor patients with dysphagia

Herbert B. Newton, Cheryl Newton, Dennis Keith Pearl, Tracy Davidson

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Dysphagia is a common problem in patients with neurologic disease and is often associated with significant morbidity and mortality. To evaluate primary brain tumor patients who complained of dysphagia, we adapted grading scales for severity of complaint and level of alertness (scale of 1 to 4) and bedside swallowing assessment and videofluoroscopic examination (scales of 1 to 5). Over 13 months, we prospectively screened 117 patients for dysphagia. Seventeen of these (14.5%) complained of dysphagia (mean age, 50.2 years; range, 20 to 75); an additional six control patients were studied from a group with no dysphagic complaints. Scoring for severity of complaint (mean, 2.3) and level of alertness (mean, 2.2) was mild-moderate in the majority of patients. Eleven of 17 patients scored ≥ grade 3 (mean 3.2, moderate impairment, requiring supervision) on bedside testing, and six of seven scored ≥ grade 3 (mean 3.8, moderate-moderately severe abnormality, trace or frequent aspiration) during videofluoroscopic evaluation. Bedside testing scores of the study group differed significantly (p < 0.001) from those of the control group. Level of alertness correlated strongly with bedside (r = 0.794) and videofluoroscopic (r = 0.780) scoring. Primary brain tumor patients with dysphagia are likely to have impairment of swallowing out of proportion to their complaints and therefore are at risk for aspiration and nutritional compromise. We recommend that these patients undergo formal swallowing assessment followed by rehabilitation or implementation of alternative feeding methods.

Original languageEnglish (US)
Pages (from-to)1927-1932
Number of pages6
JournalNeurology
Volume44
Issue number10
StatePublished - 1994

Fingerprint

Deglutition
Deglutition Disorders
Brain Neoplasms
Feeding Methods
Dysphagia
Brain Tumor
Nervous System Diseases
Rehabilitation
Morbidity
Control Groups
Mortality
Complaints

All Science Journal Classification (ASJC) codes

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Neuroscience(all)

Cite this

Newton, H. B., Newton, C., Pearl, D. K., & Davidson, T. (1994). Swallowing assessment in primary brain tumor patients with dysphagia. Neurology, 44(10), 1927-1932.
Newton, Herbert B. ; Newton, Cheryl ; Pearl, Dennis Keith ; Davidson, Tracy. / Swallowing assessment in primary brain tumor patients with dysphagia. In: Neurology. 1994 ; Vol. 44, No. 10. pp. 1927-1932.
@article{94d4817ca3f5481d9ac3f856a847511f,
title = "Swallowing assessment in primary brain tumor patients with dysphagia",
abstract = "Dysphagia is a common problem in patients with neurologic disease and is often associated with significant morbidity and mortality. To evaluate primary brain tumor patients who complained of dysphagia, we adapted grading scales for severity of complaint and level of alertness (scale of 1 to 4) and bedside swallowing assessment and videofluoroscopic examination (scales of 1 to 5). Over 13 months, we prospectively screened 117 patients for dysphagia. Seventeen of these (14.5{\%}) complained of dysphagia (mean age, 50.2 years; range, 20 to 75); an additional six control patients were studied from a group with no dysphagic complaints. Scoring for severity of complaint (mean, 2.3) and level of alertness (mean, 2.2) was mild-moderate in the majority of patients. Eleven of 17 patients scored ≥ grade 3 (mean 3.2, moderate impairment, requiring supervision) on bedside testing, and six of seven scored ≥ grade 3 (mean 3.8, moderate-moderately severe abnormality, trace or frequent aspiration) during videofluoroscopic evaluation. Bedside testing scores of the study group differed significantly (p < 0.001) from those of the control group. Level of alertness correlated strongly with bedside (r = 0.794) and videofluoroscopic (r = 0.780) scoring. Primary brain tumor patients with dysphagia are likely to have impairment of swallowing out of proportion to their complaints and therefore are at risk for aspiration and nutritional compromise. We recommend that these patients undergo formal swallowing assessment followed by rehabilitation or implementation of alternative feeding methods.",
author = "Newton, {Herbert B.} and Cheryl Newton and Pearl, {Dennis Keith} and Tracy Davidson",
year = "1994",
language = "English (US)",
volume = "44",
pages = "1927--1932",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

Newton, HB, Newton, C, Pearl, DK & Davidson, T 1994, 'Swallowing assessment in primary brain tumor patients with dysphagia', Neurology, vol. 44, no. 10, pp. 1927-1932.

Swallowing assessment in primary brain tumor patients with dysphagia. / Newton, Herbert B.; Newton, Cheryl; Pearl, Dennis Keith; Davidson, Tracy.

In: Neurology, Vol. 44, No. 10, 1994, p. 1927-1932.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Swallowing assessment in primary brain tumor patients with dysphagia

AU - Newton, Herbert B.

AU - Newton, Cheryl

AU - Pearl, Dennis Keith

AU - Davidson, Tracy

PY - 1994

Y1 - 1994

N2 - Dysphagia is a common problem in patients with neurologic disease and is often associated with significant morbidity and mortality. To evaluate primary brain tumor patients who complained of dysphagia, we adapted grading scales for severity of complaint and level of alertness (scale of 1 to 4) and bedside swallowing assessment and videofluoroscopic examination (scales of 1 to 5). Over 13 months, we prospectively screened 117 patients for dysphagia. Seventeen of these (14.5%) complained of dysphagia (mean age, 50.2 years; range, 20 to 75); an additional six control patients were studied from a group with no dysphagic complaints. Scoring for severity of complaint (mean, 2.3) and level of alertness (mean, 2.2) was mild-moderate in the majority of patients. Eleven of 17 patients scored ≥ grade 3 (mean 3.2, moderate impairment, requiring supervision) on bedside testing, and six of seven scored ≥ grade 3 (mean 3.8, moderate-moderately severe abnormality, trace or frequent aspiration) during videofluoroscopic evaluation. Bedside testing scores of the study group differed significantly (p < 0.001) from those of the control group. Level of alertness correlated strongly with bedside (r = 0.794) and videofluoroscopic (r = 0.780) scoring. Primary brain tumor patients with dysphagia are likely to have impairment of swallowing out of proportion to their complaints and therefore are at risk for aspiration and nutritional compromise. We recommend that these patients undergo formal swallowing assessment followed by rehabilitation or implementation of alternative feeding methods.

AB - Dysphagia is a common problem in patients with neurologic disease and is often associated with significant morbidity and mortality. To evaluate primary brain tumor patients who complained of dysphagia, we adapted grading scales for severity of complaint and level of alertness (scale of 1 to 4) and bedside swallowing assessment and videofluoroscopic examination (scales of 1 to 5). Over 13 months, we prospectively screened 117 patients for dysphagia. Seventeen of these (14.5%) complained of dysphagia (mean age, 50.2 years; range, 20 to 75); an additional six control patients were studied from a group with no dysphagic complaints. Scoring for severity of complaint (mean, 2.3) and level of alertness (mean, 2.2) was mild-moderate in the majority of patients. Eleven of 17 patients scored ≥ grade 3 (mean 3.2, moderate impairment, requiring supervision) on bedside testing, and six of seven scored ≥ grade 3 (mean 3.8, moderate-moderately severe abnormality, trace or frequent aspiration) during videofluoroscopic evaluation. Bedside testing scores of the study group differed significantly (p < 0.001) from those of the control group. Level of alertness correlated strongly with bedside (r = 0.794) and videofluoroscopic (r = 0.780) scoring. Primary brain tumor patients with dysphagia are likely to have impairment of swallowing out of proportion to their complaints and therefore are at risk for aspiration and nutritional compromise. We recommend that these patients undergo formal swallowing assessment followed by rehabilitation or implementation of alternative feeding methods.

UR - http://www.scopus.com/inward/record.url?scp=0028000006&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028000006&partnerID=8YFLogxK

M3 - Article

C2 - 7936249

AN - SCOPUS:0028000006

VL - 44

SP - 1927

EP - 1932

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 10

ER -

Newton HB, Newton C, Pearl DK, Davidson T. Swallowing assessment in primary brain tumor patients with dysphagia. Neurology. 1994;44(10):1927-1932.