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

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