RT Journal Article
SR Electronic
T1 Presence of aspiration pneumonia is independently associated with mortality, after adjusting for age, disease severity, and comorbities
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4365
VO 42
IS Suppl 57
A1 Michael Lanspa
A1 Paula Peyrani
A1 Timothy Wiemken
A1 Julio Ramirez
A1 Nathan Dean
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4365.abstract
AB Background: Patients with aspiration pneumonia are older and have more comorbid conditions. It is unknown whether presence of aspiration pneumonia independently increases mortality, or merely signifies greater comorbidities.Methods: We performed a secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) database, which retrospectively collected data from 43 hospitals in 12 countries, between June 2001 and December 2012. We included adult patients who met criteria for community-acquired pneumonia (CAP). Presence of aspiration pneumonia was determined clinically. We performed a propensity-matched analysis, comparing patients with and without aspiration pneumonia, accounting for age, disease severity, and comorbidities.Results: We identified 451 patients with aspiration and 4734 patients with non-aspiration CAP. Patients with aspiration pneumonia were older (median 79 vs. 69, p < 0.001), had greater comorbidities, and presented with greater disease severity. Patients with aspiration pneumonia had greater pneumonia severity index scores (median 123 vs. 92, p < 0.001), increased hospital length-of-stay (median 9 vs. 7 days, p <0.001), and increased in-hospital mortality (41% vs. 26%, p < 0.001). The propensity-matched analysis, adjusted for age, disease severity, and comorbidities, demonstrated that aspiration pneumonia independently conferred a 2.32 (95% CI 1.56-3.45, p < 0.001) odds ratio for in-hospital mortality compared to non-aspiration pneumonia.Conclusions: Patients with aspiration pneumonia are more likely to die than those with non-aspiration pneumonia, even after adjusting for age, disease severity, and comorbidities.