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Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia

Authors
 Hee-Young Yoon  ;  Sung Shine Shim  ;  Soo Jung Kim  ;  Jin Hwa Lee  ;  Jung Hyun Chang  ;  Su Hwan Lee  ;  Yon Ju Ryu 
Citation
 JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, Vol.20(9) : 1098-1104.e4, 2019 
Journal Title
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
ISSN
 1525-8610 
Issue Date
2019
Keywords
Aspiration pneumonia ; elderly ; mortality ; prognosis ; recurrent aspiration
Abstract
OBJECTIVES: Aspiration pneumonia is a leading cause of death among older patients; however, little is known about the long-term mortality in aspiration pneumonia. The purpose of this study was to evaluate long-term mortality and its associated factors in patients with aspiration pneumonia.

DESIGN: Retrospective cohort study.

SETTING AND PARTICIPANTS: In total, 550 patients with aspiration pneumonia (median age: 78.0 years, 66.4% male) with compatible clinical symptoms and chest computed tomography images were enrolled at a single tertiary center from 2006 to 2016.

MEASURES: The 1-, 3-, and 5-year mortality rates were evaluated for all patients. The prognostic factors for 1-year and 5-year mortality were also evaluated using Cox proportional hazard models.

RESULTS: A total of 441 (80.2%) patients died during a median follow-up of 50.7 weeks. The 1-, 3-, and 5-year mortality rates were 49.0%, 67.1%, and 76.9%, respectively. Multivariate analysis identified 5 risk factors for 1-year mortality of male sex [hazard ratio (HR) 1.533, P = .003], low body mass index (HR 0.934, P = .002), hypoalbuminemia, anemia (0.973, P = .032), and mechanical ventilation (HR 2.052, P < .001), which were also independent prognostic factors for 5-year mortality. During the follow-up period, 133 (24.2%) patients experienced recurrent aspiration pneumonia. However, Kaplan-Meier analysis showed no significant differences in survival curves between patients with single and recurrent aspiration pneumonia (P = .371).

CONCLUSIONS/IMPLICATIONS: Long-term prognosis of aspiration pneumonia was poor as a result of underlying morbidity instead of the aspiration pneumonia itself. Our findings suggest that prognostic indices for patients with aspiration pneumonia including the patient's underlying conditions should be devised.
Full Text
https://www.sciencedirect.com/science/article/pii/S152586101930324X
DOI
10.1016/j.jamda.2019.03.029
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173165
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