ABSTRACT NUMBER: ESOC2026A1870 PREDICTION OF SWALLOWING RECOVERY IN 436 PATIENTS WITH SEVERE POST STROKE DYSPHAGIA: DATA FROM THE PHEAST TRIAL OF PHARYNGEAL ELECTRICAL STIMULATION

Abstract Background and aims Post-stroke dysphagia (PSD) is common after stroke. The Predictive Swallowing Score (PRESS) predicts swallowing recovery and includes: age, impairment (NIHSS), stroke location, aspiration risk and FOIS score. Methods We assessed PRESS in people with tube-dependent PSD (FOIS score 1-3) who had been enrolled into the international PhEAST trial which is assessing pharyngeal electrical stimulation (PES) vs none. Baseline data included PRESS components and total score (but not frontal opercular lesion). Outcome was the dysphagia severity rating scale (DSRS, PhEAST primary outcome) and return of oral nutrition (feeding status scale, FSS<2) at 90 days. Data were analysed using binary and linear regression without adjustment for PES assignment. Results 436 PhEAST participants had complete data. At baseline: age 75.1 (SD 12.4), female 164 (37.6%), NIHSS 13.0 (7.5), onset-to-randomisation 15 [IQR 9-21] days, DSRS 12 [11-12], FOIS 1 [1-2], FSS 2 [2- 2], PRESS 7 [5-8]. After excluding 101 (23.2%) people who had died by 90 days: DSRS 1 [0-5], FOIS 5 [1-7], FSS<2 284 (84.8%). In univariate analyses age, FOIS and PRESS were each related to day 90 DSRS (r>0.20, P<0.001); age was associated with FSS<2 (r=-0.16, P=0.004). In multiple-variable step-down analyses, age and FOIS were associated with day 90 DSRS and FOIS, and age was associated with FSS<2 (P<0.05). Conclusions By 90 days, a majority of surviving people with severe tube-dependent post-stroke dysphagia had returned to oral feeding. Age was the most powerful predictor of swallowing return by day 90. The effect of PES on outcomes is being assessed in PhEAST. Conflict of interest Lisa J Woodhouse: nothing to declare. Cameron Skinner: nothing to declare. Patrick Smith: nothing to declare. Lisa Everton: nothing to declare. Karl Matz: nothing to declare. Shaheen Hamdy: employee of Phagenesis Ltd. Philip M Bath: received devices and training from Phagenesis Ltd