Identifying Risk Factors for Aspiration in Patients Hospitalized with Community-Acquired Pneumonia

Abstract

Background. Aspiration pneumonia (AP) is difficult to diagnose and has poor outcomes. This case-control study aimed to explore the risk factors and delineate the antibiotic usage for AP. Methods. Inpatients diagnosed with community-acquired pneumonia (CAP) from 2013 to 2017, enrolled in the urban employee basic medical insurance program in Beijing, were included and classified into the AP (N = 2,885) and non-AP (N = 53,825) groups. Risk factors were identified by logistic regression. Results. Older age (compared to 18–64 years, OR for 65–79 years: 4.3, 95% CI: 3.8–4.9; OR for >80 years: 6.3, 95% CI: 5.6–7.2), male (OR: 1.4, 95% CI: 1.3–1.5), cerebrovascular disease (OR: 3.1, 95% CI: 2.8–3.5), dementia (OR: 2.0, 95% CI: 1.8–2.1), vomiting (OR: 1.4, 95% CI: 1.2–1.7), Parkinson’s disease (OR: 2.1, 95% CI: 1.8–2.4), and epilepsy (OR: 3.2, 95% CI: 2.8–3.7) were associated with an increased risk of AP. 92.8% of the AP patients received antibiotic therapy. Among them, patients treated with broad-spectrum antibiotics, antibiotics for injection, and combined antibiotics accounted for 93.3%, 97.9%, and 81.7%, respectively. Conclusions. Older age, male, and several comorbidities were independent risk factors for AP, and combined antibiotics treatments are common, which merits attention in accurate detection of AP in a high-risk population.

Machine learning predictive model for aspiration risk in early enteral nutrition patients with severe acute pancreatitis

“…Age was one of the risk factors for aspiration. With the increase of age, the functions of each organ of the body shows different degrees of physiological decline, especially the re ex function and swallowing function [33]. Moreover, elderly patients are often complicated with a variety of internal medical diseases such as cardiovascular and cerebrovascular diseases and pulmonary diseases, so age becomes an important cause of aspiration [34].…”

Microbiological Profile of Patients with Aspiration Pneumonia Identified by Combined Detection Methods

“…Our data showed that patients with AP were more inclined to be older and to have a higher prevalence of different underlying conditions, particularly diabetes mellitus, chronic heart disease, and cerebrovascular disease, which was generally consistent with previous reports. 18 , 22 The integrity of the oropharyngeal sensory system is essential for maintaining swallowing function. With the increase of age and underlying diseases, pharyngeal sensitivity and swallowing reactivity impaired, the protective reflex of epiglottis and glottis reduced, especially in the setting of cerebrovascular diseases, the swallowing function and cough reflex impaired, leading to an increased risk of AP.…”

“…2,3 AspRF includes advanced age, male, dysphagia, head and neck cancer, upper gastrointestinal disease, reduced conscious level, degenerative neurologic diseases (parkinsonism, dementia, and multiple sclerosis), chronic obstructive pulmonary disease, alcohol dependence, and sedative drug abuse. 2,3,18 AspRF-CAP was defined as CAP patients with AspRF. 3,9 A total of 94 patients with CAP from three hospitals were eligible for screening (Figure 1).…”

Decrease in Tongue Pressure in Frail Patients in the Sitting Position and Its Alleviation by Plantar Grounding

“…However, VE requires highly experienced staff and is somewhat invasive to the patient. In addition to these three phases, cognitive and masticatory functions must be assessed to achieve feeding without aspiration [18,19]. Cognitive function contributes to the recognition of the size or hardness of food and movement of the appropriate amount of food into the oral cavity.…”