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We have developed the Predictive Swallowing Score (PRESS) - an easily applicable prognostic risk score of impaired oral intake after stroke. The 10 point score is calculated after the initial swallowing evaluation in the first days after stroke and showed excellent discrimination and calibration for the indication of tube feeding and PEG feeding.
The main aim of this multicenter study is to internally and externally validate the PRESS in four Swiss stroke centers. A well-validated score might help clinicians assess the risk of long-term impairment of oral intake. Second, it may guide therapeutic decisions, in particular early administration of enteral nutrition and the choice of the appropriate feeding route (e.g. nasogastric tube or PEG feeding). Third, it may assist clinicians with informing patients and relatives about long term expectations of their swallowing outcome. Finally, it may be used in nonrandomized trials to control for case-mix variation.
We will conduct a prospective multicenter cohort study in four Swiss stroke centres: St. Gallen, Bern, Aarau and Basel. The study duration will be 2 years to recruit a sufficient number of severely impaired patients. Included will be acute stroke patients with a severe initial impairment of oral intake. They will receive a baseline visit with neurologic, logopedic and radiologic assessments, as well as two follow-up visits after 7 and 30 days. The primary outcome parameter will be the recovery of severe impairment of oral intake after 7 and 30 days measured with the Functional Oral Intake Scale (FOIS).