Repetitive saliva swallowing test and water swallowing test may identify a COPD phenotype at high risk of exacerbation

Abstract

Introduction Patients with chronic obstructive pulmonary disease (COPD) are known to present with dysphagia from an early stage. Dysphagia leads to swallowing‐related complications, in turn leading to COPD exacerbation. Dysphagia screening is recommended; however little is known of its utility in detecting a COPD phenotype at risk for exacerbation. The simple swallowing provocation test (SSPT), considered to be a standard screening test, requires specific equipment, physician skill and patient discomfort. Objectives The aim of this study was to find an easier and less invasive measure to screen for dysphagia in patients with COPD. Methods We retrospectively reviewed patients with COPD who were screened for dysphagia [Repetitive saliva swallowing test (RSST), water swallowing test (WST), SSPT and a questionnaire] from June to November 2016. The patients were classified into two groups according to the presence of COPD exacerbation in the past 3 years (ie, exacerbation and non‐exacerbation group), and the dysphagia screening results were compared between the groups. Results Of the 80 cases included, 42 had 1 or more exacerbations in the past 3 years (exacerbation group), and 38 had none (non‐exacerbation group). Statistically significant differences between the groups were observed in the RSST, and vocal change in the WST (P < 0.05). There were no significant differences between the groups in the results of SSPT, COPD stage and other clinical status. Conclusions Compared to the SSPT, RSST and WST may be more appropriate screening methods in patients with COPD. A prospective study is necessary for further assessment.

Interferential Current Stimulation for Swallowing Disorders in Chronic Obstructive Pulmonary Disease: A Preliminary Study

“…As shown in our previous study, the optimal cutoff value of swallow screening tests is different in stable COPD patients (in whom the swallowing disorder is often subclinical) than in more apparent swallowing disorders associated with stroke or neurological conditions. 4 , 5 ) Therefore, the significant differences shown in Fig. 2 may be of importance even if the results were unchanged with respect to the commonly applied thresholds (as in Table 2 ).…”

“…However, it has been shown that a low RSST has a high impact on the risk of future exacerbation. 4 , 5 ) The long-term effects of IFC-TESS and improvements in RSST will be determined in the future.…”

“…Patients with an RSST score of 5 or less were found to be at risk of COPD exacerbation. 5) The mechanisms and appropriate screening methods for COPD exacerbation are being clarified, and the next step is to investigate effective ways to treat this population; however, evidence on interventions to improve swallowing function is still extremely limited. It is hoped that physiotherapy and swallow training may be effective.…”

“…3 ) In our previous study, we investigated the efficacy of the repetitive saliva swallowing test (RSST) in screening for COPD patients who are at risk of exacerbation. 4 , 5 ) The RSST, in which patients are asked to swallow as many times as possible in 30 s, is a simple and noninvasive method used to screen for dysphagia. Patients with an RSST score of 5 or less were found to be at risk of COPD exacerbation.…”

High-flow nasal cannula oxygen therapy was effective for dysphagia associated with respiratory muscle paralysis due to cervical spinal cord injury

“…An assessment of swallowing function revealed no paralysis of the tongue or face. In the repetitive saliva swallowing test (RSST: normal is more than 3 times per 30 s), [7] he swallowed six times in 30 s. However, he had wet hoarseness in 3 mL of thick water-swallowing test. Therefore, only indirect therapy (without food) was performed.…”