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Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia

Title
Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia
Authors
Yoon, Hee-YoungShim, Sung ShineKim, Soo JungLee, Jin HwaChang, Jung HyunLee, Su HwanRyu, Yon Ju
Ewha Authors
장중현이진화심성신류연주김수정윤희영
SCOPUS Author ID
장중현scopusscopus; 이진화scopus; 심성신scopus; 류연주scopus; 김수정scopus
Issue Date
2019
Journal Title
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
ISSN
1525-8610JCR Link

1538-9375JCR Link
Citation
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION vol. 20, no. 9, pp. 1098 - +
Keywords
Aspiration pneumoniaelderlyprognosismortalityrecurrent aspiration
Publisher
ELSEVIER SCIENCE INC
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
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. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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DOI
10.1016/j.jamda.2019.03.029
Appears in Collections:
의과대학 > 의학과 > Journal papers
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