Over 45% of patients with bronchiectasis have impaired swallow function

Key takeaways:

• Swallow function was evaluated using three scoring systems, one of which was patient-reported.
• Researchers found a link between less efficient swallowing and three decreased factors.

BOSTON — In a sample of 114 adults with bronchiectasis, 46.5% received a score that indicated impaired swallow function, according to a presentation at the CHEST Annual Meeting.

“Overall, our findings demonstrated that dysphagia is indeed prevalent in this patient population, although we saw no differences in negative vs. positive [non-tuberculosis mycobacteria] status,” Yaerin Song, BA, medical student at Rutgers Robert Wood Johnson Medical School, said during her presentation.

In a retrospective chart review, Song and colleagues assessed swallow evaluations from 114 adults (89 women) with bronchiectasis using videofluoroscopic swallowing study to determine how prevalent impaired swallow function, or oropharyngeal dysphagia, is via three scoring/rating systems: the Eating Assessment Tool (EAT-10; patient-reported), the Penetration-Aspiration Scale (PAS) and the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST).

Each adult was given 5 swallowing tasks — 5 mL thin liquid, 10 mL thin liquid, continuous thin liquid, 5 mL puree and solid — to carry out twice, which translates to 1,140 swallows from this study population.

Notably, 74 patients had positive non-tuberculosis mycobacteria status, and when looking at swallow assessments, a positive status did not significantly differ from a negative status, according to Song.

Based on the notion that a PAS score of 3 or higher signaled impaired swallow function, researchers reported that 4.2% of the 570 worst swallow scores for each tested consistency met this criterion. In terms of EAT-10 (n = 64), Song said 31.3% of patients had difficulty swallowing based on achievement of a score of 3 or higher.

Nearly half (46.5%) of patients received an overall DIGEST grade of 1 or higher that indicated impaired swallow function. When divided into DIGEST safety and efficiency, Song said 15.8% of patients had unsafe swallowing and 43.9% had inefficient swallowing.

During regression analysis, researchers found a link between less efficient swallowing and three decreased factors: BMI (OR = 0.9; 95% CI, 0.83-0.97), FVC percent predicted (OR = 0.98; 95% CI, 0.96-0.99) and FEV₁ percent predicted (OR = 0.98; 95% CI, 0.96-0.99).

“Given that there is a high prevalence of dysphagia in this patient population, considering comprehensive swallow assessment in this patient population could be useful,” Song said during the presentation.

Song additionally said literature supporting swallow treatment shows treating earlier could be beneficial in curbing aspiration events.

“Allowing that earlier identification of dysphagia, since a lot of these patients can present silently, we can help prevent or mitigate future aspiration events, and hoping to prevent also further exacerbation coming from aspiration and the complications,” Song continued.