Clinical detection of silent aspiration in acute stroke (Version 1.1)
Research type
Research Study
Full title
Feasibility study for identification of patients at potential risk of silent aspiration in an acute stroke setting: a comparison of clinical swallow examination and cough reflex testing
IRAS ID
280542
Contact name
Julie Trimble
Contact email
Sponsor organisation
Newcastle upon Tyne Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 1 months, 31 days
Research summary
Dysphagia (swallowing difficulty) is a common side-effect of stroke, affecting between 50-70% of stroke patients. Patients with silent aspiration (food or drink entering the lung in the absence of a cough response) are approximately 13 times more likely to develop pneumonia than those with normal swallowing. Other consequences of post-stroke dysphagia include increased length of hospital stay and increased mortality secondary to pneumonia.
This study aims to determine feasibility for a pilot study comparing the efficacy of cough reflex testing to identify patients who are at risk of silent aspiration compared with usual care (clinical swallow examination - CSE).
The study will be carried out on an acute stroke unit (Royal Victoria Infirmary, Newcastle) with patients with a confirmed or suspected new diagnosis of stroke within 3 days of the onset of their stroke symptoms. 10 patients will be recruited to the feasibility study over a 1 to 2 month period.
Participants will all receive the same care. This includes usual care which involves an observation of them eating and drinking (CSE). They will also receive cough reflex testing (CRT), a test to look at the sensory and motor response of the cough which involves inhaling a cough-inducing solution via a nebuliser and rate acceptability of this test. Participants will also receive a fibreoptic endoscopic evaluation of swallowing (FEES) which is one of the gold standard assessments for identification of silent aspiration.
Results from this study will inform the feasibility of a definitive study to determine whether CRT is more effective than CSE (or subcomponents of CRT) for identification of patients at risk of silent aspiration with a long-term view to potential reduction in incidence of pneumonia, length of hospital stay and mortality with acute stroke patients.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
20/NE/0189
Date of REC Opinion
21 Aug 2020
REC opinion
Favourable Opinion