Aspiration and severe exacerbations in COPD: a prospective study
| العنوان: | Aspiration and severe exacerbations in COPD: a prospective study |
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| المؤلفون: | Christian R. Osadnik, Kais Hamza, Philip G. Bardin, Paul Leong, Lydia Cvejic, Nadine Guiney, Martin MacDonald, Paul T. King, Kenneth K. Lau, Tiffany Nicholson, Paul Finlay |
| المصدر: | ERJ Open Research, Vol 7, Iss 1 (2021) ERJ Open Research article-version (VoR) Version of Record |
| بيانات النشر: | European Respiratory Society, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, COPD, business.industry, lcsh:R, Corticosteroid treatment, lcsh:Medicine, Mean age, Emergency department, Original Articles, Tertiary care hospital, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Internal medicine, Medicine, Respiratory system, 030223 otorhinolaryngology, Prospective cohort study, business, Silent aspiration |
| الوصف: | Rationale Swallow may be compromised in COPD leading to aspiration and adverse respiratory consequences. However, prevalence and consequences of detectable aspiration in stable COPD are not known. Objectives We tested the hypothesis that a significant number of patients with stable COPD will have detectable aspiration during swallow (prandial aspiration) and that they would experience more frequent severe acute exacerbations of COPD (AECOPD) over the subsequent 12 months. Methods Patients (n=151) with verified and stable COPD of all severities were recruited at a tertiary care hospital. Videofluoroscopy was conducted to evaluate aspiration using Rosenbek's scale for penetration–aspiration during 100-mL cup drinking. AECOPD was documented as moderate (antibiotics and/or corticosteroid treatment) or severe (emergency department admission or hospitalisation) over the ensuing 12 months. Measurements and main results Aspiration was observed in 30 out of 151 patients (19.9%, 18 males, 12 females; mean age 72.4 years). Patients with aspiration had more overall AECOPD events (3.03 versus 2 per patient; p=0.022) and severe AECOPD episodes (0.87 versus 0.39; p=0.032). Severe AECOPD occurred in more patients with aspiration (50% of patients versus 18.2%; OR 4.5, CI 1.9–10.5; p=0.001) and with silent aspiration (36.7% versus 18.2%; OR 2.6, CI 1.1–6.2; p=0.045). Aspiration was related to a shorter exacerbation-free period during the 12-month follow-up period (p=0.038). Conclusions Prandial aspiration is detectable in a subset of patients with COPD and was predictive of subsequent severe AECOPD. Studies to examine if the association is causal are essential to direct strategies aimed at prevention of aspiration and AECOPD. This study demonstrates that prandial aspiration occurs in ∼20% of patients with stable COPD and portends severe COPD exacerbations over the next 12 months https://bit.ly/2Tx5btj |
| اللغة: | English |
| تدمد: | 2312-0541 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b8fe6b15096344d8baa4f3dc8cf2210d http://openres.ersjournals.com/content/7/1/00735-2020.full |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....b8fe6b15096344d8baa4f3dc8cf2210d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 23120541 |
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