Swallowing dysfunction after extubation is frequent after prolonged invasive ventilation.

Except for stroke patients, a bedside screening tool is still needed in the ICU setting.

We developed a new bedside accurate tool to detect swallowing dysfunction.

Our test could be a useful screening test in ICU to avoid unnecessary examination.

A negative test would allow to resume oral feeding earlier in critically ill survivors.

A bedside screening tool of swallowing dysfunction (SD) (BSSD) after extubation would be useful to identify patients who are at risk of SD. We aimed to evaluate the accuracy of our BSSD in comparison with fiberoptic endoscopic evaluation of swallowing (FEES) in critically ill patients after extubation.

We conducted a 1-year prospective monocentric study to evaluate the accuracy of our BSSD to diagnose SD following endotracheal intubation in comparison with FEES (gold standard). Patients intubated for longer than 48 h were included. Both tests were assessed within 24 h after extubation. Primary endpoint was the accuracy of the BSSD. Secondary endpoint was to assess risk factors of SD.

Seventy-nine patients were included in the study. Thirty-three patients (42%) presented with a SD. The BSSD showed a sensitivity of 88% (95% CI 0.72–0.97) and a specificity of 91% (95% CI 0.79–0.98), a positive predictive value of 88% (95% CI 0.72–0.97) and a negative predictive value of 91% (95% CI 0.79–0.97). The AUC reached 0.83 (95% CI 0.74–0.92).

Our study describes an accurate clinical screening tool to detect SD after extubation in critically ill patients. Screening-positive cases should be confirmed by instrumental tests, ideally using FEES.

Swallowing dysfunction

Fiberoptic endoscopy

Extubation

Aspiration

Pneumonia

Endotracheal intubation

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