Association of Dysphonia in Patients With Dysphagia in the United States: A National Database Study.
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OBJECTIVE: Limited research exists on the prevalence and comorbidity of dysphagia and dysphonia, though prior studies highlight their co-existence in multiple disease cohorts. This study investigates the prevalence of dysphonia in U.S. adults with dysphagia. METHODS: A cross-sectional study was conducted using the NIH's All of Us Research Program controlled tier dataset (version 7). Multivariate logistic regression and marginal effects (ME) examined the association of dysphonia in U.S. adults with dysphagia. RESULTS: Among 266,612 adults, 24,198 had dysphagia (median age, 67 years; 63% female), and 242,414 did not (median age, 58 years; 61% female). Dysphonia was significantly more prevalent in patients with dysphagia (14% vs. 1.9%, p < 0.001). Multivariate analysis showed a 6.78-fold increase in odds of dysphonia with dysphagia (95% CI 6.47-7.11; ME 9.82%). Dysphagia was significantly associated with dysphonia in patients with head and neck cancer (aOR 2.93; ME 13.51%), stroke (aOR 3.71; ME 14.56%), neurodegenerative conditions (aOR 4.34; ME 13.16%), COPD (aOR 4.33; ME 13.35%), ACDF (aOR 5.24; ME 18.90%), and vocal fold abnormalities (aOR 1.40; ME 7.71%). CONCLUSION: Patients with dysphagia had a 6.78-fold increase in odds of having a diagnosis of dysphonia. Otolaryngologists and speech-language pathologists should consider dysphonia assessment in their patients presenting with dysphagia.