Skip to main content
The Egyptian Journal of Otolaryngology
Download PDF
  • Original article
  • Open access
  • Published:

Application of the GUSS test on adult Egyptian dysphagic patients

The Egyptian Journal of Otolaryngology volume 33, pages 103–110 (2017)Cite this article

Abstract

Background

The evaluation of swallowing disorders and their rehabilitative modalities is an important topic. The benefit to the patient, in terms of improvement in quality of life, cannot be underestimated. Bedside tests might be used to identify patients with oropharyngeal dysphagia and to identify those who are at a risk for aspiration.

Aim

The aim of the present study was to evaluate the validity and reliability of the Gugging Swallowing Screening (GUSS) test for the detection of aspiration and swallowing abnormalities in dysphagic Egyptian patients. This helps in better management.

Study design

The present study was a comparative, cross-sectional study.

Patients and methods

A total of 42 patients were referred from the outpatient clinics with a complaint of dysphagia. All patients were evaluated using flexible endoscopic examination of swallowing (FEES) and the GUSS test. The results of these two methods were compared to assess validity. Reliability was approved by the assessment of the Cohen’s κ agreement between the two independent raters.

Results

The mean age of the patients was 51.6±12.2 years. According to the results of FEES, 28 (66.7%) patients were at a risk for aspiration, whereas 30 (71.4%) patients were rated to be at a risk according to the GUSS test results. According to the cutoff of 14 points, GUSS reached 93.3% sensitivity and 83.3% specificity when compared with FEES. Positive predictive value was 93.3% and negative predictive value was 83.3%. The results of reliability (by comparing the scores of the two raters as regards the degree of severity) showed excellent agreement between the two raters (κ=0.84, P>0.05, PO=91%).

Conclusion

GUSS test proved to be an easy, valid, and reliable test to predict the risk for aspiration among the adult Egyptian patients.

References

  1. Leder SB, Espinosa JF. Aspiration risk after acute stroke: comparison of clinical examination and fiberoptic endoscopic evaluation of swallowing. Dysphagia 2002; 17:214–218.

    Article  Google Scholar 

  2. Park Y-H, Han H-R, Oh B-M, Lee J, Park J-a, Yu SJ, et al. Prevalence and associated factors of dysphagia in nursing home residents. Geriatr Nurs (Minneap) 2013; 34:212–217.

    Article  Google Scholar 

  3. Wakasugi Y, Tohara H, Hattori F, Motohashi Y, Nakane A, Goto S, et al. Screening test for silent aspiration at the bedside. Dysphagia 2008; 23:364–370.

    Article  Google Scholar 

  4. Alagiakrishnan K, Fisher C, Kurian M. Mealtime challenges and swallowing difficulties in elderly dementia patients. Chapter 108. In: Preedy CRMR, eds. Diet and nutrition in dementia and cognitive decline San Diego: Academic Press; 2015;1149–1158.

    Chapter  Google Scholar 

  5. Hirano I, Kahrilas PJ. A 78-year-old man with difficulty swallowing. Clin Gastroenterol Hepatol 2011; 9:470–474.

    Article  Google Scholar 

  6. Barnard SL. Nursing dysphagia screening for acute stroke patients in the emergency department. J Emerg Nurs 2011; 37:64–67.

    Article  Google Scholar 

  7. Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, et al. Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen. Stroke 2007; 38:2948–2952.

    Article  Google Scholar 

  8. Langmore SE, Schatz K, Olson N. Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol 1991; 100:678–681.

    Article  CAS  Google Scholar 

  9. Shem KL, Castillo K, Wong SL, Chang J, Kao M-C, Kolakowsky-Hayner SA. Diagnostic accuracy of bedside swallow evaluation versus videofluoroscopy to assess dysphagia in individuals with tetraplegia. PM&R 2012; 4:283–289.

    Article  Google Scholar 

  10. Martino R, Silver F, Teasell R, Bayley M, Nicholson G, Streiner DL, et al. The Toronto Bedside Swallowing Screening Test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke. Stroke 2009; 40:555–561.

    Article  Google Scholar 

  11. Cichero JAY, Heaton S, Bassett L. Triaging dysphagia: nurse screening for dysphagia in an acute hospital. J Clin Nurs 2009; 18: 1649–1659.

    Article  Google Scholar 

  12. Suiter DM, Leder SB. Clinical utility of the 3-ounce water swallow test. Dysphagia 2008; 23:244–250.

    Article  Google Scholar 

  13. Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs 2009; 65:477–493.

    PubMed  Google Scholar 

  14. Altman DG. Practical statistics for medical research. New York, NY Chapman & Hall/CRC Press 1999.

    Google Scholar 

  15. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A Penetration-Aspiration Scale. Dysphagia 1996; 5:93–98.

    Article  Google Scholar 

  16. Li L, Zhang L-h, Xu W-p, Hu J-m. Risk assessment of ischemic stroke associated pneumonia. World J Emerg Med 2014; 5:209–213.

    Article  Google Scholar 

  17. Hassan HE, Aboloyoun AI. The value of bedside tests in dysphagia evaluation. Egypt J Ear Nose Throat Allied Sci 2014; 15:197–203.

    Article  Google Scholar 

  18. DePippo KL, Holas MA, Reding MJ, Mandel FS, Lesser ML. Dysphagia therapy following stroke: a controlled trial. Neurology 1994; 44: 1655–1660.

    Article  CAS  Google Scholar 

  19. Daniels SK, McAdam CP, Brailey K, Foundas AL. Clinical assessment of swallowing and prediction of dysphagia severity. Am J Speech-Language Pathol 1997; 617.

  20. Hinds NP, Wiles CM. Assessment of swallowing and referral to speech and language therapists in acute stroke. QJM 1998; 91:829–835.

    Article  CAS  Google Scholar 

  21. Logemann JA, Veis S, Colangelo LA. Screening procedure for oropharyngeal dysphagia. Dysphagia J 1999; 14:44–51.

    Article  CAS  Google Scholar 

  22. Edmiaston J, Connor LT, Steger-May K, Ford AL. A simple bedside stroke dysphagia screen, validated against videofluoroscopy, detects dysphagia and aspiration with high sensitivity. J Stroke Cerebrovasc Dis 2013; 23:712–716.

    Article  Google Scholar 

  23. Norton B, Homer-Ward M, Donnelly MT, Long RG, Holmes GK. A randomized prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ 1996; 312:13–16 63.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Unit of Phoniatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Ahmed AbdelHamid (MD phoniatrics)

  2. Department of Otorhinolaryngology, Phoniatrics Unit, Faculty of Medicine, Minia University, Minia, Egypt

    Ahmed Abo-Hasseba

Authors
  1. Ahmed AbdelHamid
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmed Abo-Hasseba
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed AbdelHamid.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

AbdelHamid, A., Abo-Hasseba, A. Application of the GUSS test on adult Egyptian dysphagic patients. Egypt J Otolaryngol 33, 103–110 (2017). https://doi.org/10.4103/1012-5574.199419

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1012-5574.199419

Keywords