Swallowing dysfunction in patients hospitalized due to a COPD exacerbation

Objectives This cross-sectional study aimed to investigate the prevalence of self-reported and clinically screened swallowing dysfunction (dysphagia) in COPD patients with severe exacerbations and to identify any associated factors. Findings were then compared to a control group.

Methods Participants included 30 patients hospitalized due to a COPD exacerbation. The control group consisted of 30 adults hospitalized with acute cardiac symptoms. Data were derived from spirometry, the 150mL timed water swallow test, a cookie swallow test and a dyspnea questionnaire (mMRC). Scores from the Eating Assessment Tool (EAT-10) were calculated to assess patient perception of swallowing dysfunction.

Results Self-reported swallowing dysfunction and clinical signs thereof was more common in COPD patients than in the control group (67% versus 23% and 80% versus 37%, respectively, p≤0.001). Clinical signs of swallowing dysfunction in the AECOPD group were associated with self-reported swallowing dysfunction (p=0.02) and xerostomia (p=0.04). Dyspnea (MRC≥2) was more common among the COPD patients (90% versus 47%, p<0.001). There was a significant negative correlation between lung function and self-reported dysphagia (r=−0.39, p=0.03), but not between lung function and clinically screened dysphagia (r=−0.23, p=0.21).

Conclusion COPD patients hospitalized with an acute exacerbation experienced significantly more self-reported and clinically screened swallowing dysfunction compared to a control group of patients with cardiac symptoms. Both patient groups experienced dyspnea, but it was twice as common in the AECOPD group. Both groups also experienced xerostomia.