Evidence map›Paper›PMID 42469330›Full record

ArticleScientific reports2026

Reliability and validity of the DEFISS score for predicting post-extubation dysphagia and dysphagia-related reintubation after stroke.

Paul Muhle, Niklas Weßeler, Anne Jung, Rainer Dziewas, Bendix Labeit, Antje Schmidt-Pogoda, Oliver Grauer, Sonja Suntrup-Krueger

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Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Paul Muhle *Department of Neurology, University Hospital Muenster, Building A1, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany. paul.muhle@ukmuenster.de.
Niklas Weßeler *Department of Neurology, University Hospital Muenster, Building A1, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Anne JungDepartment of Neurology, University Hospital Muenster, Building A1, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Rainer DziewasDepartment of Neurology, Klinikum Osnabrück, Osnabrück, Germany.
Bendix LabeitDepartment of Neurology, University Hospital Duesseldorf, Düsseldorf, Germany.
Antje Schmidt-PogodaDepartment of Neurology, University Hospital Muenster, Building A1, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Oliver GrauerDepartment of Neurology, University Hospital Muenster, Building A1, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
Sonja Suntrup-KruegerDepartment of Neurology, University Hospital Muenster, Building A1, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Post-extubation dysphagia is frequent after severe stroke and can lead to pneumonia, delayed recovery, and dysphagia-related reintubation. We evaluated the Determine Extubation Failure in Severe Stroke (DEFISS) score, a bedside tool combining stroke-specific clinical factors, duration of mechanical ventilation, and a brief oral motor function assessment to support pre-extubation risk stratification. In a prospective single-center cohort, three blinded raters (novice, intermediate, expert) independently scored DEFISS immediately before planned extubation, which followed routine clinical care. After extubation, all patients underwent flexible endoscopic evaluation of swallowing by assessors blinded to DEFISS. The primary outcome was dysphagia-related reintubation within 120 h, and construct validity was assessed against the Fiberoptic Endoscopic Dysphagia Severity Scale. Thirty-nine stroke patients (mean age 73.9 ± 11.6 years; 54% female) were included; five (12.8%) experienced dysphagia-related reintubation. Interrater reliability was excellent (ICC_single 0.887; ICC_average 0.959), with similarly high reliability for the oral motor function component (ICC_single 0.874). DEFISS correlated with endoscopic dysphagia severity (ρ = 0.44, p = 0.005). Using a prespecified cutoff (DEFISS ≥ 4), odds of dysphagia-related reintubation increased (OR 11.1, p = 0.035) with sensitivity 0.80 and specificity 0.73. DEFISS may provide a pragmatic triage tool to prioritize early FEES and targeted dysphagia management in critically ill stroke patients.

Indexed as

Airway ExtubationDeglutition DisordersIntubation, IntratrachealStrokeAgedAged, 80 and overFemaleHumansMaleMiddle AgedProspective StudiesReproducibility of ResultsRespiration, ArtificialSeverity of Illness IndexDysphagiaExtubation failureFEDSSFEESIntensive careInterrater reliabilityStroke

Identifiers

PMID42469330
PMCPMC13379578

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