{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:31:14Z","timestamp":1793730674308,"version":"4.6.1"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Dysphagia is independently associated with adverse outcomes in intensive care units (ICU). Early identification through dysphagia screening does not occur routinely, negatively impacting optimal patient management. This study aimed to validate the Swedish version of the Gugging Swallowing Screen\u2014Intensive Care Unit (<jats:italic>GUSS\u2010IVA<\/jats:italic>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective multicentre study of 56 adult ICU patients with endotracheal intubation exceeding 48\u2009h at three hospitals in Sweden. The GUSS\u2010ICU was translated into Swedish (GUSS\u2010IVA) and used to screen all prolonged intubated patients (&gt;48\u2009h) once extubated. The GUSS\u2010IVA screen was conducted by ICU nursing staff and then compared with a gold standard Flexible Endoscopic Evaluation of Swallowing (FEES) within 2 h of the GUSS\u2010IVA screen. Fifty\u2010one of 56 patients underwent FEES (where assessors were blinded to the GUSS\u2010IVA screen results). Sensitivity and specificity were calculated, as was the area under the receiver operating characteristic curves (AUC) with 95% confidence intervals (CI). For inter\u2010rater reliability, within 2 h of the initial screen, 29\/56 patients were GUSS\u2010IVA screened a second time by a nursing staff blinded to the first GUSS\u2010IVA results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 56 patients, 38 (67.9%) were identified as dysphagic using the GUSS\u2010IVA screen. With FEES, 42 of 51 patients (82.4%) were diagnosed with dysphagia; of these, 16 (31.4%) were classified as aspirating. Compared to FEES, GUSS\u2010IVA showed high sensitivity and specificity values (81% and 89%, respectively) with an AUC of 0.85 (95% CI: 0.71\u20130.95) and a positive predictive value of 97%. High convergent validity was obtained for GUSS\u2010IVA compared with the Dysphagia Outcome Severity Scale (\u0278\u2009=\u20090.57, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and the Functional Oral Intake Scale (\u0278\u2009=\u20090.52, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and moderate validity with the Penetration\u2010Aspiration Scale (\u0278\u2009=\u20090.30, <jats:italic>p<\/jats:italic>\u2009=\u2009.033). The inter\u2010rater reliability showed moderate agreement (Cohen's kappa <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.501, <jats:italic>p<\/jats:italic>\u2009=\u2009.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study indicates that the Swedish GUSS\u2010IVA is a valid and reliable screen to identify dysphagic ICU patients. Given the negative impact of dysphagia on short and long\u2010term patient outcomes, the Swedish GUSS\u2010IVA is recommended as an essential first step by nursing staff for early identification of dysphagia for further diagnostics and subsequent patient management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.70031","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T02:25:07Z","timestamp":1743301507000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Identifying dysphagia in the intensive care unit: Validation of the Swedish version of the Gugging swallowing screen\u2014Intensive care unit"],"prefix":"10.1111","volume":"69","author":[{"given":"Anna","family":"Schandl","sequence":"first","affiliation":[{"name":"Department of Perioperative and Intensive Care S\u00f6dersjukhuset  Stockholm Sweden"},{"name":"Department of Clinical Sciences and Education S\u00f6dersjukhuset, Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza","family":"Bergstr\u00f6m","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, Division of Neurology, Department of Clinical Sciences Karolinska Institute, Danderyd Hospital  Stockholm Sweden"},{"name":"Speech\u2010Language Pathology unit, Remeo Intensive Care Rehabilitation Center  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Selg","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, Department of Clinical Sciences, Faculty of Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Eliasson","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, Department of Neurology Danderyd Hospital  Stockholm Sweden"},{"name":"Internal Medicine Clinic, Department for Stroke and Neurological Disorders S\u00f6dersjukhuset  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Hyl\u00e8n","sequence":"additional","affiliation":[{"name":"Department of Intensive and Perioperative Care Sk\u00e5ne University Hospital  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Silfwerbrand","sequence":"additional","affiliation":[{"name":"Department of Neurology Sk\u00e5ne University Hospital  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Nymark","sequence":"additional","affiliation":[{"name":"Department of Perioperative and Intensive Care S\u00f6dersjukhuset  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"McGreevy","sequence":"additional","affiliation":[{"name":"Department of Dietetics Region S\u00f6rmland  Nyk\u00f6ping Sweden"},{"name":"Centre for Clinical Research S\u00f6rmland Uppsala University  Eskilstuna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Brorsson","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care, Department of Diagnostics and Intervention, Faculty of Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorbj\u00f6rn","family":"Holmlund","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology, Department of Clinical Sciences, Faculty of Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"H\u00e4gglund","sequence":"additional","affiliation":[{"name":"Speech and Language Pathology, Department of Clinical Sciences, Faculty of Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Svenska intensivv\u00e5rdsregistret\/The Swedish Intensive Care Registry.\u00c5rsrapport 2023\/Annual Report 2023. 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