A Tough Pill to Swallow: Bedside Dysphagia Screening in Geriatric Trauma Patients

Heather R Kregel; Jan-Michael Van Gent; Harper Halfacre; Georgia Fabbrini; Deukwoo Kwon; David E Meyer; Laura Moore; Lillian S Kao; Thaddeus J Puzio

doi:10.1016/j.jss.2025.09.091

A Tough Pill to Swallow: Bedside Dysphagia Screening in Geriatric Trauma Patients

J Surg Res. 2025 Nov:315:908-914. doi: 10.1016/j.jss.2025.09.091. Epub 2025 Nov 5.

Authors

Heather R Kregel¹, Jan-Michael Van Gent², Harper Halfacre², Georgia Fabbrini², Deukwoo Kwon³, David E Meyer⁴, Laura Moore⁴, Lillian S Kao⁴, Thaddeus J Puzio⁴

Affiliations

¹ Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas. Electronic address: Heather.Kregel@uth.tmc.edu.
² Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
³ Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
⁴ Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.

PMID: 41197588
DOI: 10.1016/j.jss.2025.09.091

Abstract

Introduction: We hypothesized that Bedside screening tests (BSTs) would identify dysphagia in geriatric trauma patients without overt swallowing difficulties.

Methods: Trauma patients ≥65 y were eligible for enrollment. Patients with known risk factors for dysphagia were excluded. All patients underwent BST by nursing and speech and language pathologist followed by a diagnostic confirmatory test for dysphagia. The primary outcomes were diagnostic test characteristics for BST.

Results: Of 139 enrolled patients, 29 (21%) had dysphagia. Median age was 78 y (interquartile range: 72-85). Nursing BST had a sensitivity of 0.12, specificity of 0.96, positive predictive value of 0.43, a negative predictive value of 0.81, and an accuracy of 0.79. Speech and language pathologist BST had a sensitivity of 0.38, specificity of 0.76, positive predictive value of 0.30, a negative predictive value of 0.82, and an accuracy of 0.68.

Conclusions: Dysphagia was present in 21% of a geriatric trauma population without overt swallowing difficulties, and BSTs had sufficient specificity for screening but poor sensitivity.

Keywords: Clinical outcomes; Dysphagia; Geriatrics; Trauma.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Aged, 80 and over
Deglutition Disorders* / diagnosis
Deglutition Disorders* / etiology
Female
Geriatric Assessment* / methods
Humans
Male
Mass Screening* / methods
Point-of-Care Testing*
Predictive Value of Tests
Sensitivity and Specificity
Wounds and Injuries* / complications

Grants and funding

T32 GM008792/GM/NIGMS NIH HHS/United States