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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

RSI (A) and RFS (B) of patients with COPD and a normal control.Abbreviations: COPD, chronic obstructive pulmonary disease; RFS, reflux finding score; RSI, reflux symptom index.
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f2-copd-10-1343: RSI (A) and RFS (B) of patients with COPD and a normal control.Abbreviations: COPD, chronic obstructive pulmonary disease; RFS, reflux finding score; RSI, reflux symptom index.

Mentions: Normal controls showed mean RFS and RSI scores of 3.13±2.83 and 3.25±3.57, respectively. RFS and RSI were significantly higher in patients with COPD (P<0.001; Figure 2). RFS findings indicated that, subglottic edema, vocal fold edema, ventricular obliteration, diffuse laryngeal edema, and posterior commissure hypertrophy were significantly prevalent or more severe in patients with COPD than in normal controls (Table 5, Figure 3).


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)

RSI (A) and RFS (B) of patients with COPD and a normal control.Abbreviations: COPD, chronic obstructive pulmonary disease; RFS, reflux finding score; RSI, reflux symptom index.
© Copyright Policy
Related In: Results  -  Collection

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

f2-copd-10-1343: RSI (A) and RFS (B) of patients with COPD and a normal control.Abbreviations: COPD, chronic obstructive pulmonary disease; RFS, reflux finding score; RSI, reflux symptom index.
Mentions: Normal controls showed mean RFS and RSI scores of 3.13±2.83 and 3.25±3.57, respectively. RFS and RSI were significantly higher in patients with COPD (P<0.001; Figure 2). RFS findings indicated that, subglottic edema, vocal fold edema, ventricular obliteration, diffuse laryngeal edema, and posterior commissure hypertrophy were significantly prevalent or more severe in patients with COPD than in normal controls (Table 5, Figure 3).

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