Work

Dysphagia in infective and non-infective exacerbations of chronic obstructive pulmonary disease: a retrospective cohort study

Year: 2026

Type: article

Abstract: OBJECTIVE: Infection and sepsis have been identified as potential risk factors for dysphagia in hospitalised patients, but their contribution relative to that of respiratory dysfunction is unclear. We used acute exacerbations of chronic obstructive pulmonary disease (COPD) as a clinical model to test whether infection is independently associated with dysphagia. METHODS: Retrospective cohort study of adults admitted with acute COPD exacerbations to a National Health Service (NHS) trust in Manchester, UK, between 2022 and 2023. Admissions were classified as infective (n=4474) or non-infective (n=608); patients with sepsis (n=556) were identified within the infective cohort. The primary outcome was new-onset dysphagia during the index admission; secondary outcomes were in-hospital mortality and length of stay (LOS). Regression models were adjusted for age, sex, frailty and Charlson Comorbidity Index. RESULTS: Dysphagia was recorded in 2.93% of infective versus 0.99% of non-infective admissions (unadjusted OR 3.03, 95% CI 1.33 to 6.89; p=0.008). Infection remained independently associated with dysphagia (adjusted OR (aOR) 2.46, 95% CI 1.08 to 5.64; p=0.033), in-hospital mortality (aOR 3.84, 2.34 to 6.31; p<0.001) and longer LOS (β 3.06 days, 1.92 to 4.20; p<0.001). Within the infective cohort, sepsis was independently associated with dysphagia (aOR 1.70, 1.09 to 2.65; p=0.019), mortality (aOR 3.13, 2.51 to 3.90; p<0.001) and prolonged LOS (β 5.39 days, 4.13 to 6.64; p<0.001). CONCLUSION: In acute COPD exacerbations, infection was independently associated with dysphagia, with the highest prevalence in sepsis. Infection may contribute to dysphagia risk beyond respiratory dysfunction alone, supporting targeted swallowing assessment in infective exacerbations, particularly when complicated by sepsis.

Source: BMJ Open Gastroenterology

DOI: 10.1136/bmjgast-2026-002494

Authors: Ayodele Sasegbon, Ishaq Shareef Mohammed, Anna Thompson, Shaheen Hamdy

Institutions: University of Manchester, Manchester University NHS Foundation Trust

Language: English

Topic: Dysphagia Assessment and Management

Subfield: Speech and Hearing

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,085