Long-Term Prognosis for Aspiration Pneumonia Is Poor Due to Underlying Morbidity
Aspiration pneumonia is a leading cause of death among the elderly. However, a new study in the September issue of JAMDA suggests that the long-term prognosis for this condition is poor due to underlying morbidity, rather than because of the aspiration pneumonia itself.
In Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia, the authors studied 550 aspiration pneumonia patients; only half of these individuals survived one year after their first aspiration event. Risk factors for one-year mortality included low body mass index, admission from another department, hypotension, cerebral infarction (as an underlying disease), bedridden status, use of inotropes or vasopressors, leukocytosis, hypoalbuminemia, and mechanical ventilatory care.
Nearly one-fourth (24.2%) of the patients studied had recurrent aspiration pneumonia, and these were more likely to be male, admitted from home, and have chronic obstructive pulmonary disease (COPD) or a tracheostomy. There were no significant differences in the survival curves between single and recurrent aspiration pneumonia groups. However, gender, admission from another institute (nursing home or hospital) or home, post-operative state, oral feeding at admission, multiple lobar involvement, COPD history, and tracheostomy status were statistically associated with recurrent aspiration pneumonia.
The study results, the authors said, suggest that “the long-term mortality of aspiration pneumonia was affected by both disease severity and preexisting conditions.” They further observed, “Our finding of no significant difference in mortality between patients with recurrent and single aspiration pneumonia also supports the importance of comorbidities in the prognosis of aspiration pneumonia, rather than the pneumonia itself.”
This study was conducted by researchers at the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Department of Radiology, College of Medicine, Ewha Woman’s University, Seoul, Republic of Korea; and Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About the Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.