The relationship between swallowing function and clinical parameters in patients with chronic obstructive pulmonary disease.

BACKGROUND

Dysphagia is considered an extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD), and its clinical significance has received increasing attention in recent years. However, data on the association between swallowing function and clinical parameters in COPD remain limited. Therefore, this study aimed to evaluate swallowing function using clinical screening tools in patients with COPD and to assess its relationship with demographic and clinical parameters.

METHODS

This cross-sectional study included 60 COPD patients who were followed jointly at the Chest Diseases and Physical Medicine and Rehabilitation outpatient clinics of a tertiary university hospital between April and July 2025. Patients' swallowing-related parameters were evaluated using the Eating Assessment Tool-10 (EAT-10) and the Repetitive Saliva Swallowing Test (RSST). Physical performance was assessed using the Six-Minute Walk Test (6MWT), respiratory function using spirometric parameters, and symptom severity using the COPD Assessment Test (CAT) and the modified Medical Research Council Dyspnea Scale (mMRC). Data analyses were performed using SPSS.

RESULTS

The mean age of patients was 68.75 ± 6.54 years, and 81.7% were male. According to the EAT-10 screening, the prevalence of self-reported dysphagia was 35%. There was a significant difference in EAT-10 scores between GOLD groups, whereas no difference was observed in RSST counts (p = 0.020, p = 0.111). Patients with mMRC ≥ 2 had higher EAT-10 scores and lower RSST counts (p = 0.043, p = 0.024) compared with those with mMRC scores < 2. Patients with CAT scores ≥ 10 had higher EAT-10 scores (p = 0.001). Those with recent weight loss also had higher EAT-10 scores and lower RSST counts (p = 0.010, p = 0.025). No significant correlations were found between swallowing-related parameters and age, BMI, smoking exposure, COPD duration, pulmonary function, or 6-MWT. However, EAT-10 scores showed positive correlations with mMRC (r = 0.356, p = 0.005) and CAT scores (r = 0.530, p < 0.001), while RSST counts showed a weak negative correlation with mMRC scores (r=-0.282, p = 0.029).

CONCLUSION

Swallowing-related parameters assessed using clinical screening tools were associated with symptom severity (mMRC and CAT) and weight loss in patients with COPD. These findings suggest that screening-based swallowing assessment may provide additional clinical information during clinical follow-up and that screening for dysphagia may be beneficial, particularly in patients with high symptom burden and recent weight loss.

TRIAL REGISTRATION: Not applicable.