Gonzalez Lindh Margareta, Janson Christer, Blom Johansson Monica, Jonsson Mimmi, Mälberg Emma, Allansson Elina, Holm Cecilia, Jennische Margareta, Koyi Hirsch
Dept of Neuroscience, Uppsala University, Uppsala, Sweden.
Centre for Research and Development, Uppsala University/Region Gävleborg, Uppsala, Sweden.
ERJ Open Res. 2021 Jun 7;7(2). doi: 10.1183/23120541.00173-2021. eCollection 2021 Apr.
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.
Participants included 30 patients hospitalised due to a COPD exacerbation. The control group consisted of 30 adults hospitalised with acute cardiac symptoms. Data were derived from spirometry, the 150 mL timed water swallow test, a cookie swallow test and a dyspnoea questionnaire (modified Medical Research Council (mMRC)). Scores from the 10-item Eating Assessment Tool (EAT-10) were calculated to assess patient perception of swallowing dysfunction.
Self-reported swallowing dysfunction and clinical signs thereof were more common in COPD patients than in the control group (67% 23% and 80% 37%, respectively; p≤0.001). Clinical signs of swallowing dysfunction in the group with acute exacerbation of COPD were associated with self-reported swallowing dysfunction (p=0.02) and xerostomia (p=0.04). Dyspnoea (mMRC ≥2) was more common among the COPD patients (90% 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).
COPD patients hospitalised 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 dyspnoea, but it was twice as common in the group with acute exacerbation of COPD. Both groups also experienced xerostomia.
本横断面研究旨在调查重度加重期慢性阻塞性肺疾病（COPD）患者自我报告及临床筛查的吞咽功能障碍（吞咽困难）的患病率，并确定相关因素。然后将结果与对照组进行比较。
研究对象包括30例因COPD加重而住院的患者。对照组由30例因急性心脏症状住院的成年人组成。数据来源于肺功能测定、150毫升定时饮水吞咽试验、饼干吞咽试验和呼吸困难问卷（改良医学研究委员会（mMRC））。计算10项饮食评估工具（EAT-10）的得分，以评估患者对吞咽功能障碍的感知。
COPD患者自我报告的吞咽功能障碍及其临床体征比对照组更常见（分别为67%对23%和80%对37%；p≤0.001）。COPD急性加重组吞咽功能障碍的临床体征与自我报告的吞咽功能障碍（p=0.02）和口干（p=0.04）相关。呼吸困难（mMRC≥2）在COPD患者中更常见（90%对47%，p<0.001）。肺功能与自我报告的吞咽困难之间存在显著负相关（r=-0.39，p=0.03），但肺功能与临床筛查的吞咽困难之间无显著负相关（r=-0.23，p=0.21）。
与有心脏症状的对照组患者相比，因急性加重而住院的COPD患者自我报告及临床筛查的吞咽功能障碍明显更多。两组患者均有呼吸困难，但在COPD急性加重组中呼吸困难的发生率是对照组的两倍。两组患者也都有口干症状。
