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Backgrounds

Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.

Methodology and Principal Findings

We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients median age: 86 years, women: 76% who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living ADL, and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects 2.6% of the total sample were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning odds ratio OR = 17.25, 95% confidence interval CI: 13.16–22.62, p < 0.001, daily oxygen therapy OR = 8.29, 95% CI: 4.39–15.65, feeding support dependency OR = 8.10, 95% CI: 6.27–10.48, p < 0.001, and urinary catheterization OR = 4.08, 95% CI: 2.81–5.91, p < 0.001. In the multiple logistic regression analysis, the risk factors associated with aspiration pneumonia after propensity-adjustment 258 subjects each were sputum suctioning OR = 3.276, 95% CI: 1.910–5.619, deterioration of swallowing function in the past 3 months OR = 3.584, 95% CI: 1.948–6.952, dehydration OR = 8.019, 95% CI: 2.720–23.643, and dementia OR = 1.618, 95% CI: 1.031–2.539.

Conclusion

The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing repetitive aspiration pneumonia.



Autor: Toshie Manabe, Shinji Teramoto , Nanako Tamiya, Jiro Okochi, Nobuyuki Hizawa

Fuente: http://plos.srce.hr/



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