The Ability of the 10-Item Eating Assessment Tool (EAT-10) to Predict Aspiration Risk in Persons With Dysphagia

Abstract

Background: Dysphagia is common and costly. The ability of patient symptoms to predict objective swallowing dysfunction is uncertain.

Purpose: This study aimed to evaluate the ability of the Eating Assessment Tool (EAT-10) to screen for aspiration risk in patients with dysphagia.

Methods: Data from individuals with dysphagia undergoing a videofluoroscopic swallow study between January 2012 and July 2013 were abstracted from a clinical database. Data included the EAT-10, Penetration Aspiration Scale (PAS), total pharyngeal transit (TPT) time, and underlying diagnoses. Bivariate linear correlation analysis, sensitivity, specificity, and predictive values were calculated.

Results: The mean age of the entire cohort (N=360) was 64.40 (±14.75) years. Forty-six percent were female. The mean EAT-10 was 16.08 (±10.25) for nonaspirators and 23.16 (±10.88) for aspirators (P<.0001). There was a linear correlation between the total EAT-10 score and the PAS (r=0.273, P<.001). Sensitivity and specificity of an EAT-10>15 in predicting aspiration were 71% and 53%, respectively.

Conclusion: Subjective dysphagia symptoms as documented with the EAT-10 can predict aspiration risk. A linear correlation exists between the EAT-10 and aspiration events (PAS) and aspiration risk (TPT time). Persons with an EAT-10>15 are 2.2 times more likely to aspirate (95% confidence interval, 1.3907-3.6245). The sensitivity of an EAT-10>15 is 71%.

Keywords: EAT-10; Eating Assessment Tool; PAS; Penetration Aspiration Scale; aspiration; aspiration risk; dysphagia; screening test; survey; symptom.