Prevalence and nature of dysphagia in VA patients with COPD referred for videofluoroscopic swallow examination.

This retrospective study investigated the prevalence and nature of dysphagia in 78 male outpatients whose primary diagnosis was chronic obstructive pulmonary disease (COPD) and who were referred for modified barium swallow studies at the Veterans Affairs Medical Center (VAMC) in Tucson, Arizona, 1992-1995. Nearly 85% of these patients evidenced some degree of dysphagia, and laryngeal penetrations or aspirations were observed in 44 of them. Agreement between VAMC swallow assessments and those of a three-judge panel of certified speech-language pathologists supported the reliability and validity of the information extracted from VAMC records. The high percentage of silent laryngeal penetrations and aspirations observed in this sample suggests that COPD patient's respiratory status should be considered as well as overt symptoms of a swallowing disorder, such as coughing, in making referrals for video-fluoroscopic swallow studies for such patients.