Prevalence And Influencing Factors Of Dysphagia In Patients With Stable Chronic Obstructive Pulmonary Disease

ObjectivesTo investigate the status of dysphagia in stable COPD patients and analyze its influencing factors,it can provide reference suggestions for reducing aspiration and improving long-term prognosis of COPD patients.MethodsFrom January to December 2021,380 stable COPD patients were selected from the respiratory department of three Grade A hospitals in Lanzhou city for cross-sectional study by convenient sampling method.A cross-sectional study of 380stable COPD patients.Research tools include:General Information Questionnaire,Disease-Related Information Form,Comprehensive Assessment Form for COPD Stable Period,Eating Assessment Tool-10（EAT-10）,Frailty Phenotype（FP）,Mini Nutritional Assessment（MNA）,Geriatric Depression Scale-15（GDS-15）,Mini-Mental State Examination（MMSE）,Barthel Index（BI）.Epidata 3.1 was used to input data and SPSS 25.0 was used for statistical analysis.If the measurement data conforms to the normal distribution,it is expressed as（X±S）,and the skewed distribution is expressed as M(P₂₅,P₇₅).Two independent sample t test,Chi-square test,Fisher’s exact probability test and Mann-Whitney U non-parametric rank sum test were used to analyze the influence of general factors on swallowing disorders in stable COPD patients.Binary Logistic regression analysis was used for multivariate analysis.P<0.05 indicated that the difference was statistically significant.Results（1）A total of 380 patients with stable COPD were included in this study,among which 157 had dysphagia,accounting for 41.3%;223 had normal swallowing,the prevalence of dysphagia is high.（2）The results of univariate analysis showed that the incidence of dysphagia was associated with different age,gender,ethnicity,educational level,marital status,living status,smoking status,history of choking,BMI,course of COPD,CAT grade,frail status,nutritional status,and cognitive function,as well as the differences in activities of daily living ability were statistically significant（P<0.05）.（3）The results of binary logistic regression analysis showed that,the likelihood of dysphagia increased with age[OR=1.088,95%CI（1.034,1.144）].Compared with han nationality,ethnic minority patients were 4.708 times more likely to develop dysphagia[OR=4.708,95%CI（1.219,18.183）].Patients with a history of choking were 32.755 times more likely to develop dysphagia than those without[OR=32.755,95%CI（15.865,67.627）].Compared with nonsmokers,smokers and former smokers were 4.446 times[OR=4.446,95%CI（1.017,19.439）]and 5.395 times[OR=5.395,95%CI（1.708,17.043）]more likely to have dysphagia,respectively.Compared with non-frailty patients,frailty patients were 7.878 times more likely to develop dysphagia[OR=7.878,95%CI（1.599,38.810）].Male patients were less likely to develop dysphagia than female patients[OR=0.218,95%CI（0.038,0.429）].Conclusion（1）The incidence of dysphagia is higher in patients with stable COPD.（2）Age,sex,ethnicity,smoking history,history of choking,and frailty were the influential factors for dysphagia in stable COPD patients.（3）It is recommended to incorporate swallowing screening into the clinical evaluation of stable COPD patients,so that clinical nurses can detect patients’swallowing disorders early,prevent adverse outcomes,and improve patients’prognosis.