Clinical features and outcomes of aspiration pneumonia compared with non-aspiration pneumonia: A retrospective cohort study

Hayashi, Makoto; Iwasaki, Takuya; Yamazaki, Yasushi; Takayasu, Hiromi; Tateno, Hidetsugu; Tazawa, Sakiko; Kato, Eisuke; Wakabayashi, Aya; Yamaguchi, Fuminori; Tsuchiya, Yutaka; Yamashita, Jun; Takeda, Norikazu; Matsukura, Satoshi; Kokubu, Fumio

doi:10.1016/j.jiac.2014.04.002

Cited by 79 publications

(90 citation statements)

References 30 publications

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“…Next, the ECOG performance status was a significant predictor of the prognosis, corresponding to previous studies in which the ECOG performance status was shown to be an important predictor of mortality in patients with pneumonia, especially among elderly patients or those with healthcare-associated pneumonia (20)(21)(22)(23). Although comorbidity and the functional status can be important factors when assessing the severity and prognosis of pneumonia (21,24), we found that the use of CCI as a scoring system for comorbidity was not a significant predictor of 30-day mortality, even on the univariate analysis. Finally, the serum albumin level was an independent predictor of the prognosis in the present study.…”

Section: Discussionsupporting

confidence: 58%

Multimarker Prognostication for Hospitalized Patients with Community-acquired Pneumonia

et al. 2016

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Objective The optimal prognostic model for community-acquired pneumonia (CAP) remains unclear. In this study, we sought to identify independent predictors of 30-day mortality in patients with CAP and to determine whether adding specific prognostic factors to each of the two clinical prediction scores could improve the prognostic yield. Methods This retrospective study involved 797 CAP patients who had been hospitalized at a tertiary referral center. The patients were categorized into two groups: those who survived and those who had died on or before 30 days after admission. Select clinical parameters were then compared between the two groups. Results During the 30-day period, there were 72 deaths (9%). We constructed two models for a multivariate analysis: one was based on a high CURB-65 score (3-5) and the other on a high pneumonia severity index (PSI) class (V). In both models, a high CURB-65 score or a high PSI class, along with the presence of dyspnea, high Eastern Cooperative Oncology Group (ECOG) performance status (3-4), and a low serum albumin level, were independent predictors of 30-day mortality. In both the CURB-65-based and PSI-based models, the addition of dyspnea, high ECOG performance status, and hypoalbuminemia (<3 g/dL) enhanced the prognostic assessment, and subsequently, the c-statistics calculated with the use of three-or four-predictor combinations exceeded 0.8. Conclusion In addition to the CURB-65 or PSI, the clinical factors of dyspnea, the ECOG performance status, and serum albumin level may be independent predictors of 30-day mortality in CAP patients. When combined with the CURB-65 or PSI, these parameters provide additional evidence for predicting poor prognoses.

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Section: Discussionsupporting

confidence: 58%

Multimarker Prognostication for Hospitalized Patients with Community-acquired Pneumonia

et al. 2016

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“…We finally included 19 studies in this systematic review: a second analysis of a multicenter retrospective international database of patients with CAP using propensity score analysis57, a secondary analysis of a prospective observational study58, four prospective observational studies59606162, ten retrospective observational studies21636465666768697071, a combined a retrospective derivation cohort and a prospective validation cohort72, two other combined a retrospective and a prospective observational studies7374. These studies were published from the USA (n = 5), France (n = 4), Japan (n = 4), Spain (n = 3), United Kingdom (n = 1), Canada (n = 1) and Switzerland (n = 1).…”

Section: Resultsmentioning

confidence: 99%

Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis

Komiya

Rubin

Kadota

et al. 2016

Sci Rep

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Aspiration pneumonia is thought to be associated with a poor outcome in patients with community acquired pneumonia (CAP). However, there has been no systematic review regarding the impact of aspiration pneumonia on the outcomes in patients with CAP. This review was conducted using the MOOSE guidelines: Patients: patients defined CAP. Exposure: aspiration pneumonia defined as pneumonia in patients who have aspiration risk. Comparison: confirmed pneumonia in patients who were not considered to be at high risk for oral aspiration. Outcomes: mortality, hospital readmission or recurrent pneumonia. Three investigators independently identified published cohort studies from PubMed, CENTRAL database, and EMBASE. Nineteen studies were included for this systematic review. Aspiration pneumonia increased in-hospital mortality (relative risk, 3.62; 95% CI, 2.65–4.96; P < 0.001, seven studies) and 30-day mortality (3.57; 2.18–5.86; P < 0.001, five studies). In contrast, aspiration pneumonia was associated with decreased ICU mortality (relative risk, 0.40; 95% CI, 0.26–0.60; P < 0.00001, four studies). Although there are insufficient data to perform a meta-analysis on long-term mortality, recurrent pneumonia, and hospital readmission, the few reported studies suggest that aspiration pneumonia is also associated with these poor outcomes. In conclusion, aspiration pneumonia was associated with both higher in-hospital and 30-day mortality in patients with CAP outside ICU settings.

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“…However, the prognosis of AP is generally worse than that of CAP. A recent report by Hayashi et al summarized treatment outcomes of AP patients, and reported a success rate of 73.5% [21]. It is important to note that the latter study defined "success" as any improvement on chest radiographs and laboratory results.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of pneumonia was based on evidence of pulmonary infiltration on chest radiography, and the acute onset of symptoms of a lower respiratory tract infection. In patients with dysphagia, and those at risk for dysphagia, we diagnosed AP based on radiographic evidence of infiltration in the posterior segments of the upper lobes, or the apical or basal segments of the lower lobes [10,11]. Patients with episodes of apparent foreign body aspiration received a diagnosis of aspiration pneumonitis, and were excluded from our study [12].…”

Section: Patientsmentioning

confidence: 99%

Efficacy of early switch from intravenous to oral antimicrobials in patients with aspiration pneumonia: A prospective observational study

Uni

Nishimura

Yamano

et al. 2015

Respiratory Investigation

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Clinical features and outcomes of aspiration pneumonia compared with non-aspiration pneumonia: A retrospective cohort study

Cited by 79 publications

References 30 publications

Multimarker Prognostication for Hospitalized Patients with Community-acquired Pneumonia

Multimarker Prognostication for Hospitalized Patients with Community-acquired Pneumonia

Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis

Efficacy of early switch from intravenous to oral antimicrobials in patients with aspiration pneumonia: A prospective observational study

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