268 Can the Swallow Screening Component of a Frailty Assessment be Used to Reliably Direct Clinical Dysphagia Assessment Referrals?

Abstract

Abstract Background The prevalence of dysphagia rises with age. It is associated with increased dependency and mortality (Smithard, 2016). The Irish Association of Speech & Language Therapists (IASLT) only supports swallow screening by trained nursing staff post stroke in acute care settings. Further research is required to establish its use with other clinical populations (IASLT, 2016). This study was performed to evaluate the use of a swallow screening tool by an interdisciplinary integrated team to identify frail older patients who require a clinical dysphagia assessment. Methods This was a prospective cohort study (N=177) of patients admitted through an acute hospital emergency department, between November 2018 and February 2019, 70 years or older, in an acute setting, who were identified as frail based on the Variable Indicative of Placement. The number of patients referred to SLT due to a positive swallow screen on CGA, conducted by a trained interdisciplinary team was compared with the number referred by the patient’s primary team. The criteria for dysphagia positive score was to answer yes to any of the swallow screen questions, which were based on risk factors for dysphagia. Results Of 177 patients, 47 (26%) screened positive for risk of dysphagia by the interdisciplinary team. Eight, who screened negative for risk of dysphagia, were referred by the patient’s primary team. One out of eight who screened negative, required a diet modification based on an SLT assessment. Conclusion A trained interdisciplinary frailty team can reliably screen for and identify risk of dysphagia. This indicates a potential for use of more standardised swallow screening protocols beyond the post stroke population into a broader cohort of patients.