Dysphagia is a clinical burden that can lead to serious complications like aspiration and pneumonia. Complications often result in longer hospital stays or an increased mortality rates. The Gugging Swallowing Screen (GUSS) assesses swallowing ability in patients by allowing separate evaluations for non-fluid and fluid textures, and is a potentially useful tool for determining the risk of aspiration and dysphagia. The purpose of this study is to analyze the validity and effectiveness of GUSS for dysphagia screening.

We conducted a systematic review by searching the following electronic databases: Medline, EMBASE, The Cochrane Library, KoreaMed, the Research Information Sharing Service, and the Korean Studies Information Service System. We included studies related to dysphagia screening with GUSS that were published in English or Korean up to November 2018.

Of 297 unique studies identified, 219 were reviewed by two independent reviewers. Finally, eight articles were identified as being relevant for this study. With regard to validity, GUSS had a sensitivity ranging from 90 to 100 percent and a specificity of between 50 and 88 percent. In addition, GUSS results significantly correlated with the results of the videofluoroscopic swallow study and the fiberoptic endoscopic evaluation of swallowing. In terms of effectiveness, early systematic dysphagia screening with GUSS by nurses reduced the duration of screening and rate of pneumonia, compared with the control group (p = 0.004). The incidence of X-ray verified pneumonia in the GUSS group was also significantly lower than in the clinical screening group (p < 0.01), although there was no difference in the occurrence of pneumonia, compared with the 10 mL water swallowing test.

Results showed that GUSS is a reliable and sensitive tool for screening patients for dysphagia. This early and systematic assessment can reduce the occurrence of aspiration and pneumonia, although further research is needed to establish the effectiveness of GUSS.