<p>Repetitive Saliva Swallowing Test Predicts COPD Exacerbation</p>

Abstract

IntroductionPredicting phenotypes at risk of chronic obstructive pulmonary disease (COPD) exacerbation is extremely important. Dysphagia is becoming recognized as one of these phenotypes. A convenient method of screening for dysphagia and COPD exacerbation risk is desired. The repetitive saliva swallowing test (RSST) is one of the least invasive dysphagia screening methods. We previously reported the possible relation between the RSST result and COPD exacerbation in a retrospective study. Based on this, we performed a prospective study to evaluate the efficacy of RSST as a predictor of COPD exacerbation and to determine its optimal cut-off value for COPD.MethodsSeventy patients with COPD were recruited. Patients underwent the following dysphagia screening tests: the 10-item Eating Assessment Tool, Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease, RSST, water swallowing test, and simple swallow provocation test. After one year, they were classified into two groups according to the presence of COPD exacerbation during the follow-up period.ResultsTwenty-seven patients had one or more exacerbations in the past year. During the follow-up period, 28 patients had one or more exacerbations (E group), and 42 had none (non-E group). There were no significant differences between the groups except for the presence of past exacerbations and the results of the RSST, when the cut-off value was set at 2, 3, 4, or 5 swallows. The number of swallows in the RSST was significantly lower in the E group than in the Non-E group. A cut-off value of 5 was the most effective. The time to first exacerbation was significantly longer in those with an RSST value of >5. The RSST was more reliable for differentiating the E group and non-E group than the presence of exacerbation in the past year (hazard ratios: 13.78 and 2.70, respectively).ConclusionAn RSST cut-off value of 5 may be a strong predictor of COPD exacerbation.

<p>Breathing–Swallowing Discoordination and Inefficiency of an Airway Protective Mechanism Puts Patients at Risk of COPD Exacerbation</p>

“…Details on patient background and dysphagia screening test results are explained in our previous study. 7 The patient background is shown in Table 1. There were 59 males (84.3%) and 11 females (15.7%).…”

“…However, dysphagia in COPD is known to be multifactorial, and sarcopenia is only one of the risk factors. 7 Furthermore, tongue pressure is only one small part of the systemic musculature. In addition, the oral coordination needed for tongue pressure measurement was difficult to achieve in some patients.…”

“…Detailed inclusion/exclusion criteria and data collection methods can be found in our previous study. 7 Briefly, patients diagnosed with COPD according to the GOLD 2017 criteria were included. 10 Those with coexisting respiratory conditions, other conditions causing dysphagia, or a poor general condition were excluded.…”

“…The secondary aim was to find an effective screening test for daily practice, by comparing the results of the swallowing monitor with the dysphagia screening tests. In addition to dysphagia screening tests taken in our previous study, 7 two more measurements were taken. The first is the skeletal muscle mass index (SMI).…”

Study on Factors Influencing Dysphagia in Elderly Patients with Chronic Obstructive Pulmonary Disease Based on Structural Equation Modeling

“…Studies have shown that management of influencing factors can effectively improve patients' swallowing function 14 . Yoshimatsu et al [3,15,16] using Logistic regression to explore the influence factors of swallowing disorder in that age, the condition of teeth and depression are the influence factors of swallowing disorder and mentioned condition, the condition of disease and chronic diseases will affect its, however, these indicators cannot be directly measured variables (latent variable), conventional regression analysis method is difficult to deal with these factors, At the same time, regression analysis takes whether the independent variable has direct effect on the dependent variable as the estimation goal, and does not consider the internal interaction of the independent variable. Structural equation model is the synthesis of factor analysis and path analysis, which can make up for the deficiency of traditional methods.…”