Objectives: Dysphagia is a prevalent condition among older adults and also a major cause of morbidity and mortality. Previous studies have reported the association between dysphagia and chronic obstructive pulmonary disease (COPD), especially during acute exacerbations. The objectives of this study was to determine the prevalence of dysphagia among patients with COPD using two different questionnaires for dysphagia screening, namely Eating Assessment Tool-10 (EAT-10) and Ohkuma questionnaire and to investigate the utility of swallowing questionnaires in predicting acute exacerbations in stable COPD patients.
Methods: This was a prospective cross-sectional study conducted in the outpatient pulmonology clinic at the Regional Center for Respiratory disease, Yeungnam University Hospital, a tertiary university hospital in Daegu, South Korea, from December 2019 to June 2020. One hundred sixty-seven patients with COPD in a stable phase, visiting the outpatient department participated in this study. Two dysphagia questionnaires were used to assess the patients’ swallowing difficulties. Based on the established cut-off value of each questionnaire, the patients were divided into two groups; dysphagic and non-dysphagic group. At the same time, all patients’ spirometry data within the past 3 months, COPD stages by the Global initiative for Chronic Obstructive Lung Disease (GOLD), Body Mass Index (BMI), the modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and Korean-Montreal Cognitive Assessment (K-MOCA) scores were obtained. In addition, the number of moderate to severe exacerbations in the previous year was assessed via electronic medical records; moderate exacerbation was defined as an exacerbation requiring treatment with systemic corticosteroids and/or antibiotics and severe exacerbation as an occasion in which the patient visited the emergency room or required hospitalization. The frequencies of acute exacerbations were compared between the dysphagic group and non-dysphagic group.
Results: According to the EAT-10 questionnaires, 19.4% (n=32) of the total had swallowing difficulty while 29.7% (n=49) patients had swallowing difficulty by the Ohkuma questionnaire. The number of AE in the previous year was significant higher in the dysphagic group compared to non-dysphagic group by the Ohkuma questionnaire (p=0.000). However, no significant difference in the number of AE was found between the dysphagic and non-dysphagic group by the EAT-10.
Conclusions: Dysphagia is a prevalent condition in the stable COPD patients. Our results also suggest that the Ohkuma questionnaires might be more useful for dysphagia screening in stable COPD patients. |
