Evidence map›Paper›PMID 42338681›Full record

ArticleERJ open research2026

The association between dysphagia and the risk of acute exacerbation of COPD: a systematic review and meta-analysis.

Xinqi Ma, Yue Zhu, Qing Zhao, Danye Li, Wenqiao Wang, Hongmei Zhao

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In one paragraph

Article in ERJ open research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xinqi MaDepartment of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, China.
Yue ZhuDepartment of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, China.
Qing ZhaoDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases and Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Danye LiDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases and Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Wenqiao WangDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases and Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Hongmei ZhaoDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases and Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute exacerbations of COPD (AECOPD) significantly impair patients' quality of life and contribute to higher healthcare burdens and mortality. Recent evidence suggests a potential link between dysphagia and AECOPD. This meta-analysis aims to quantitatively evaluate the impact of dysphagia on the risk of AECOPD. Methods: A comprehensive systematic search was conducted across multiple databases, including PubMed, SinoMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) and the Cochrane Library, to identify cohort studies reporting on the association between dysphagia and AECOPD. The search covered all publications from the inception of each database up to 31 May 2025. Two researchers independently performed literature screening, data extraction and quality assessment. Meta-analysis was performed using RevMan 5.4 and Stata 15.0, with pooled risk ratios calculated employing the Mantel-Haenszel method under a random effects model. Results: Seven studies involving 669 patients were included in the analysis. Meta-analysis showed that dysphagia significantly increased both the risk of AECOPD (rate ratio 2.37 (95% CI 1.75-3.20); p<0.00001) and the annual number of annual exacerbations (mean difference 1.13 (95% CI 0.88-1.38); p<0.00001). The Egger test indicated publication bias (p=0.022); after trim-and-fill adjustment, the revised rate ratio was 1.85 (95% CI 1.35-2.53). Sensitivity analyses confirmed the robustness of these results. Subgroup analyses according to publication year, country, age, study design, lung function, dysphagia assessment methods, definition of a frequent exacerbator and study quality did not significantly change the results. Conclusion: This systematic review and meta-analysis shows a significant association between dysphagia and increased risk of AECOPD. The findings highlight the importance to add swallowing function screening to standard COPD management. Future research should explore underlying mechanisms and potential confounders further.

Identifiers

PMID42338681
PMCPMC13284799

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