Determinants of Hospital Stay, Mortality, and Readmission in Aspiration Pneumonia Patients
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Original Research
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Determinants of Hospital Stay, Mortality, and Readmission in Aspiration Pneumonia Patients

1. Marmara University Faculty of Medicine Department of Pulmonology and Intensive Care, İstanbul, Turkey
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Received Date: 13.02.2024
Accepted Date: 27.06.2024
Online Date: 20.11.2024
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Abstract

Objective: Aspiration pneumonia (AP) is an important subset of pneumonia in elderly. This study aimed to identify risk factors affecting hospital length of stay (LoS), mortality, and readmission in patients with AP.

Materials and Methods: This retrospective observational study analyzed data from 263 patients hospitalized with a diagnosis of AP (n=133) and community-acquired pneumonia (n=130) between December 2020 and November 2023.

Results: Dementia/Parkinson’s disease (p<0.001), cerebrovascular accident (p<0.001), motor neuron disease (p<0.001), polypharmacy (p<0.001) and sedative drug usage (p<0.001) were common in AP patients as risk factors for aspiration. Additionally, LoS (p<0.001), mortality (p<0.001) and readmission (p<0.001) were common in the AP group. Readmission mortality for the AP group was 57.1%. Multivariate analyses of factors contributing to increased LoS were the presence of a caregiver (p=0.014), need for intensive care unit (ICU) during hospitalization (p=0.006), ICU LoS (p<0.001) and hospital admission within the last 90 days (p=0.02). Risk factors for readmission included high Charlson Comorbidity Index (CCI) (p=0.032), fever at admission (p=0.008) and ICU need during hospitalization (p=0.028). For in-hospital mortality, a lower body mass index (BMI) (p=0.01), more than one caregiver (p=0.045) and increased hospital LoS (p=0.028) were identified as independent risk factors.

Conclusion: Extended hospitalization for AP is associated with the recent hospitalization, need for care, ICU admission requirement, and prolonged ICU stay. Fever upon admission, high CCI, and ICU need were associated with an increased risk of readmission, whereas independent indicators of mortality included high care needs, low BMI, and prolonged hospitalization.

Keywords:
Aging, aspiration pneumonia, demography of older populations, home and community-based services, readmission