Work

The association between dysphagia and the risk of acute exacerbation of COPD: a systematic review and meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background: Acute exacerbations of COPD (AECOPD) significantly impair patients' quality of life and contribute to higher healthcare burdens and mortality. Recent evidence suggests a potential link between dysphagia and AECOPD. This meta-analysis aims to quantitatively evaluate the impact of dysphagia on the risk of AECOPD. Methods: A comprehensive systematic search was conducted across multiple databases, including PubMed, SinoMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) and the Cochrane Library, to identify cohort studies reporting on the association between dysphagia and AECOPD. The search covered all publications from the inception of each database up to 31 May 2025. Two researchers independently performed literature screening, data extraction and quality assessment. Meta-analysis was performed using RevMan 5.4 and Stata 15.0, with pooled risk ratios calculated employing the Mantel-Haenszel method under a random effects model. Results: Seven studies involving 669 patients were included in the analysis. Meta-analysis showed that dysphagia significantly increased both the risk of AECOPD (rate ratio 2.37 (95% CI 1.75-3.20); p<0.00001) and the annual number of annual exacerbations (mean difference 1.13 (95% CI 0.88-1.38); p<0.00001). The Egger test indicated publication bias (p=0.022); after trim-and-fill adjustment, the revised rate ratio was 1.85 (95% CI 1.35-2.53). Sensitivity analyses confirmed the robustness of these results. Subgroup analyses according to publication year, country, age, study design, lung function, dysphagia assessment methods, definition of a frequent exacerbator and study quality did not significantly change the results. Conclusion: This systematic review and meta-analysis shows a significant association between dysphagia and increased risk of AECOPD. The findings highlight the importance to add swallowing function screening to standard COPD management. Future research should explore underlying mechanisms and potential confounders further.

Source: ERJ Open Research

DOI: 10.1183/23120541.01328-2025

Authors: Xinqi Ma, Yue Zhu, Qing Zhao, Danye Li, Wenqiao Wang, Hongmei Zhao

Institutions: Capital Medical University, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College

Language: English

Topic: Chronic Obstructive Pulmonary Disease (COPD) Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $808