Obstructive Lung Diseases: Airways 4 |

COPD and the Risk of Aspiration on Fiberoptic Endoscopic Evaluation of Swallowing (FEES) FREE TO VIEW

Yaser Dawod, MD; Choua Thao, MD; Annie Ward, MS; Maria Luraschi-Monjagatta, MD
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Division of Pulmonary and Critical Care Medicine, University of Nevada School of Medicine, Las Vegas, NV

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):869A. doi:10.1016/j.chest.2016.08.969
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Recent reports have suggested an impairment in swallowing function and higher risk of aspiration in COPD patients. The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is one of the preferred methods that is currently used at the bedside to study the process of swallowing in hospitalized patients which provides static and dynamic evaluation of the structures involved during the swallowing process. We aimed to evaluate dysphagia and risk of aspiration in COPD in a consecutive cohort of patients who underwent swallowing evaluation performed by speech language pathologist.

METHODS: A retrospective chart review evaluating all patients who received FEES study during their hospitalization at the University Medical Center in Las Vegas, NV in the period between June 2014 to Oct. 2015. All subjects less than 45 years old were excluded. COPD patients were identified based on a documented history of having a disease. Subjects were stratified into two groups based on their COPD status. FEES results were interpreted by a certified speech pathologist and the degree of abnormality was evaluated based on airway invasion and risk of aspiration. Demographic and clinical data were captured. Univariate analysis was performed for all variables and those meeting a statistical threshold of P<0.2 was included in multivariate analysis.

RESULTS: A total of 205 subjects met our inclusion and exclusion criteria. COPD patients represented 11% (N=23) with a mean age of 62.6 (+ 0.8), high male prevalence 82% (N=19) and average body mass index of 27 with no statistical difference between the study groups. On univariate analysis, COPD patients had a higher prevalence of FEES abnormality when compared to non COPD patients (21 (91.3%) vs. 132 (72.7%); OR 3.9, p=0.03). After adjusting for age, BMI, stroke prevalence and Charlson Comorbidity Index on multivariate analysis, COPD patients remained to have a statistically significant association with swallowing dysfunction (OR 4.4; p=0.03).

CONCLUSIONS: This study indicates a possible significant association between COPD and dysphagia demonstrated by FEES study.

CLINICAL IMPLICATIONS: We suggest that COPD patients might be at higher risk of aspiration. Further studies are needed to predict at-risk patients and assess COPD individuals who may benefit from an early FEES study evaluation.

DISCLOSURE: The following authors have nothing to disclose: Yaser Dawod, Choua Thao, Annie Ward, Maria Luraschi-Monjagatta

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