Dysphagia in infective and non-infective exacerbations of chronic obstructive pulmonary disease: a retrospective cohort study
- 1Division of Diabetes, Endocrinology and Gastroenterology, The University of Manchester, Manchester, UK
- 2Manchester University NHS Foundation Trust, Manchester, UK
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.
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BibTeX
@article{sasegbon2026dysphagia,
title = {{Dysphagia in infective and non-infective exacerbations of chronic obstructive pulmonary disease: a retrospective cohort study}},
author = {Ayodele Sasegbon and Ishaq Shareef Mohammed and Anna Thompson and Shaheen Hamdy},
journal = {BMJ Open Gastroenterology},
year = {2026},
month = oct,
doi = {10.1136/bmjgast-2026-002494},
url = {https://doi.org/10.1136/bmjgast-2026-002494},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Dysphagia in infective and non-infective exacerbations of chronic obstructive pulmonary disease: a retrospective cohort study
AU - Ayodele Sasegbon
AU - Ishaq Shareef Mohammed
AU - Anna Thompson
AU - Shaheen Hamdy
PY - 2026
DA - 2026/10/26
JO - BMJ Open Gastroenterology
DO - 10.1136/bmjgast-2026-002494
UR - https://doi.org/10.1136/bmjgast-2026-002494
AB - 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.
SN - 2054-4774
ER -