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Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease.

Jung YH, Lee DY, Kim DW, Park SS, Heo EY, Chung HS, Kim DK - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: Positive RFS (>7) and RSI (>13) were observed in 51 (42.5%) and six patients (5.0%), respectively.RFS was significantly correlated with residual volume/total lung capacity (%, P=0.048).Scores for diffuse laryngeal edema, erythema, and hyperemia were significantly higher in the high-risk group (Global Initiative for Chronic Obstructive Lung Disease classification C and D; P=0.025 and P=0.049, respectively), while RSI was significantly higher in the more symptomatic group (Global Initiative for Chronic Obstructive Lung Disease classification B and D; P=0.047).

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background: Although chronic obstructive pulmonary disease (COPD) is closely associated with gastroesophageal reflux disease (GERD), the clinical significance of laryngopharyngeal reflux (LPR) is not fully understood in COPD.

Methods: Prospective cohorts were established among 118 patients with COPD from March 2013 to July 2014. Thirty-two age-matched and sex-matched normal controls, who had routine health check-ups during the study period, were included. Laryngopharyngeal reflux finding scores (RFS) and reflux symptom index (RSI) for LPR were subjected to association analysis with severity and acute exacerbation of COPD during the 1-year follow-up.

Results: The mean age of patients enrolled in the study was 69.2±8.8 years, with 93.2% being male. Positive RFS (>7) and RSI (>13) were observed in 51 (42.5%) and six patients (5.0%), respectively. RFS and RSI were significantly higher in patients with COPD than in normal, healthy patients (P<0.001). RFS was significantly correlated with residual volume/total lung capacity (%, P=0.048). Scores for diffuse laryngeal edema, erythema, and hyperemia were significantly higher in the high-risk group (Global Initiative for Chronic Obstructive Lung Disease classification C and D; P=0.025 and P=0.049, respectively), while RSI was significantly higher in the more symptomatic group (Global Initiative for Chronic Obstructive Lung Disease classification B and D; P=0.047). RSI and RFS were significant predictors for severe acute exacerbation of COPD (P=0.03 and P=0.047, respectively), while only RSI was associated with severity of dyspnea.

Conclusion: Laryngeal examination and evaluation of laryngeal reflux symptom could be a surrogate clinical indicator related to severe acute exacerbation of COPD. Further studies of LPR in COPD patients should be considered.

No MeSH data available.


Related in: MedlinePlus

Correlation of reflux symptom index and finding score with post FEV1 (%) (A, B), RV/TLC (%) (C, D), and DLCO (%) (E, F) in patients with COPD.Abbreviations: COPD, chronic obstructive pulmonary disease; DLCO, carbon monoxide diffusing capacity; FEV1, forced expiratory volume in 1 second; RFS, reflux finding score; RSI, reflux symptom index; RV, residual volume; TLC, total lung capacity.
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f1-copd-10-1343: Correlation of reflux symptom index and finding score with post FEV1 (%) (A, B), RV/TLC (%) (C, D), and DLCO (%) (E, F) in patients with COPD.Abbreviations: COPD, chronic obstructive pulmonary disease; DLCO, carbon monoxide diffusing capacity; FEV1, forced expiratory volume in 1 second; RFS, reflux finding score; RSI, reflux symptom index; RV, residual volume; TLC, total lung capacity.

Mentions: Multivariate analysis revealed that no parameter was significantly associated with acute moderate exacerbation. However, both RSI (continuous or dichotomous) and RFS (continuous) were significantly associated with acute severe exacerbation (P=0.03, P=0.01, and P=0.047, respectively; Table 3). There was a significant negative correlation between RFS and residual volume/total lung capacity (%) in simple correlation analysis (P=0.048), while correlation of RFS and RSI with forced expiratory volume in 1 second (FEV1; %), residual volume/total lung capacity (%), and diffusing capacity of the lungs for carbon monoxide (%) showed no significant correlation (Figure 1). With regard to the severity of dyspnea measured with the modified Medical Research Council scale, RSI was a significant predictor for severe dyspnea after adjusting for age, sex, body mass index, and FEV1% predicted (Table 4).


Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease.

Jung YH, Lee DY, Kim DW, Park SS, Heo EY, Chung HS, Kim DK - Int J Chron Obstruct Pulmon Dis (2015)

Correlation of reflux symptom index and finding score with post FEV1 (%) (A, B), RV/TLC (%) (C, D), and DLCO (%) (E, F) in patients with COPD.Abbreviations: COPD, chronic obstructive pulmonary disease; DLCO, carbon monoxide diffusing capacity; FEV1, forced expiratory volume in 1 second; RFS, reflux finding score; RSI, reflux symptom index; RV, residual volume; TLC, total lung capacity.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4507795&req=5

f1-copd-10-1343: Correlation of reflux symptom index and finding score with post FEV1 (%) (A, B), RV/TLC (%) (C, D), and DLCO (%) (E, F) in patients with COPD.Abbreviations: COPD, chronic obstructive pulmonary disease; DLCO, carbon monoxide diffusing capacity; FEV1, forced expiratory volume in 1 second; RFS, reflux finding score; RSI, reflux symptom index; RV, residual volume; TLC, total lung capacity.
Mentions: Multivariate analysis revealed that no parameter was significantly associated with acute moderate exacerbation. However, both RSI (continuous or dichotomous) and RFS (continuous) were significantly associated with acute severe exacerbation (P=0.03, P=0.01, and P=0.047, respectively; Table 3). There was a significant negative correlation between RFS and residual volume/total lung capacity (%) in simple correlation analysis (P=0.048), while correlation of RFS and RSI with forced expiratory volume in 1 second (FEV1; %), residual volume/total lung capacity (%), and diffusing capacity of the lungs for carbon monoxide (%) showed no significant correlation (Figure 1). With regard to the severity of dyspnea measured with the modified Medical Research Council scale, RSI was a significant predictor for severe dyspnea after adjusting for age, sex, body mass index, and FEV1% predicted (Table 4).

Bottom Line: Positive RFS (>7) and RSI (>13) were observed in 51 (42.5%) and six patients (5.0%), respectively.RFS was significantly correlated with residual volume/total lung capacity (%, P=0.048).Scores for diffuse laryngeal edema, erythema, and hyperemia were significantly higher in the high-risk group (Global Initiative for Chronic Obstructive Lung Disease classification C and D; P=0.025 and P=0.049, respectively), while RSI was significantly higher in the more symptomatic group (Global Initiative for Chronic Obstructive Lung Disease classification B and D; P=0.047).

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background: Although chronic obstructive pulmonary disease (COPD) is closely associated with gastroesophageal reflux disease (GERD), the clinical significance of laryngopharyngeal reflux (LPR) is not fully understood in COPD.

Methods: Prospective cohorts were established among 118 patients with COPD from March 2013 to July 2014. Thirty-two age-matched and sex-matched normal controls, who had routine health check-ups during the study period, were included. Laryngopharyngeal reflux finding scores (RFS) and reflux symptom index (RSI) for LPR were subjected to association analysis with severity and acute exacerbation of COPD during the 1-year follow-up.

Results: The mean age of patients enrolled in the study was 69.2±8.8 years, with 93.2% being male. Positive RFS (>7) and RSI (>13) were observed in 51 (42.5%) and six patients (5.0%), respectively. RFS and RSI were significantly higher in patients with COPD than in normal, healthy patients (P<0.001). RFS was significantly correlated with residual volume/total lung capacity (%, P=0.048). Scores for diffuse laryngeal edema, erythema, and hyperemia were significantly higher in the high-risk group (Global Initiative for Chronic Obstructive Lung Disease classification C and D; P=0.025 and P=0.049, respectively), while RSI was significantly higher in the more symptomatic group (Global Initiative for Chronic Obstructive Lung Disease classification B and D; P=0.047). RSI and RFS were significant predictors for severe acute exacerbation of COPD (P=0.03 and P=0.047, respectively), while only RSI was associated with severity of dyspnea.

Conclusion: Laryngeal examination and evaluation of laryngeal reflux symptom could be a surrogate clinical indicator related to severe acute exacerbation of COPD. Further studies of LPR in COPD patients should be considered.

No MeSH data available.


Related in: MedlinePlus