Oral health assessment in acute dysphagic stroke

  • Research type

    Research Study

  • Full title

    Feasibility and criterion validity of The Holistic and Reliable Oral Assessment Tool (THROAT) in acute dysphagic stroke patients.

  • IRAS ID

    161543

  • Contact name

    Craig Smith

  • Contact email

    craig.smith-2@manchester.ac.uk

  • Sponsor organisation

    The University of Manchester

  • Research summary

    Pneumonia is a frequent complication of stroke which increases the likelihood of death and poor clinical outcome. Oral disease (tooth loss/decay, and inflammation of the gums and bone supporting the teeth) are frequently found in patients suffering stroke. Passage of harmful bacteria from the oral cavity into the lungs due to swallowing problems after stroke could contribute to development of stroke-associated pneumonia (SAP). Interventions to improve oral health could therefore be a potential strategy to prevent SAP. However, we currently have no oral assessment tools for stroke unit nursing staff, the frontline staff providing mouth care, that have been comprehensively tested in acute dysphagic stroke patients. The Holistic and Reliable Oral Assessment Tool (THROAT) is an oral assessment tool for nursing staff which may have value in acute stroke patients. In this study we will determine:
    (1) If it is feasible for nursing staff to undertake the THROAT in patients with acute dysphagic stroke;
    (2) If the THROAT is valid when compared to a "gold-standard" assessment by a research dental hygienist (concurrent validity);
    (3) The number of patients required for a follow-on study to see if the THROAT is valid in predicting development of SAP (predictive validity).
    Patients with confirmed stroke presenting within 24h of onset and with swallowing problems identified from their clinical swallow test will be screened for eligibility. A stroke research nurse will record baseline data and undertake one THROAT assessment. The research hygienist will undertake one detailed dental assessment, without knowing the results of the THROAT assessment. Subsequent study visits will be undertaken by a research nurse at each 48h interval to end of study at day 8-10, and will include the following: swallowing/nutrition status, antibiotic prescription, standardised screening tool for diagnosis of SAP.

  • REC name

    Wales REC 5

  • REC reference

    14/WA/1153

  • Date of REC Opinion

    6 Oct 2014

  • REC opinion

    Further Information Favourable Opinion